Snake (Vipera berus) bite: The cause of severe anaphylactic shock and hepatocellular injury.

Vipera berus bites lead to a variety of clinical manifestations. Local swelling, coagulopathy, nephrotoxicity, cardiac effects and myotoxicity are known to be associated with envenoming by a viper bite. Although a variety of clinical manifestations have been reported in viper bite cases, anaphylactic reactions and liver injury events have not been described. We report a unique case of an anaphylaxis and transitional liver cell injury due to a Vipera berus bite in the case of a 58-year-old man with no past history suggestive of allergy and liver disease. These observations need to be further explored with laboratory studies to identify the venom components which could have pre-disposed the patient to the development of these complications.