Envenoming by Bothrops jararaca in Brazil: association between venom antigenaemia and severity at admission to hospital

Franca, F. O. S., Barbaro, K. C., Fan, H. W., Cardoso, J. L. C., Sano-Martins, I. S., Tomy, S. C., Lopes, M. H., Warrell, David A. and Theakston, R.David G. (2003) 'Envenoming by Bothrops jararaca in Brazil: association between venom antigenaemia and severity at admission to hospital'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 97, Issue 3, pp. 312-317.

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Abstract

The association between the clinical severity of Bothrops jararaca envenoming at admission and serum venom and plasma fibrinogen concentrations before antivenom administration is reported in 137 patients admitted to Hospital Vital Brazil, Instituto Butantan, Sao Paulo, Brazil, between 1989 and 1990. Other variables such as age, gender, site of the bite, use of tourniquet and the time interval between the bite and start of antivenom therapy, spontaneous systemic bleeding, and the 20 minute whole blood clotting test (20WBCT) at admission showed no association with either severity or serum venom antigen concentration (SVAC). Mean SVAC in patients with mild envenoming was significantly lower than in the group with moderate envenoming (P = 0.0007). Patients with plasma fibrinogen concentrations > 1.5 g/L had a lower mean SVAC than patients with plasma fibrinogen concentrations less than or equal to 1.5 g/L (P = 0.02). Those admitted with a tourniquet in place had significantly higher plasma fibrinogen concentrations than those without a tourniquet (P = 0.002). A multiple logistic regression model showed independent risk factors for severity: bites at sites other than legs or forearms, SVACs greater than or equal to 400 ng/mL, and the use of a tourniquet. Rapid quantification of SVAC before antivenom therapy might improve initial evaluation of severity in B. jararaca bites.

Item Type:	Article
Subjects:	QW Microbiology and Immunology > Antigens and Antibodies. Toxins and Antitoxins > QW 630 Toxins. Antitoxins WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Animal Poisons > WD 410 Reptiles WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 310 Mechanism of blood coagulation. Hemostatis
Digital Object Identifer (DOI):	https://doi.org/10.1016/s0035-9203(03)90158-1
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	30 May 2013 10:36
Last Modified:	21 Nov 2024 14:25
URI:	https://archive.lstmed.ac.uk/id/eprint/2542

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