A comparative study of severe scorpion envenomation in children caused by Tityus bahiensis and Tityus serrulatus

Bucaretchi, Fábio; Baracat, Emílio Ce; Nogueira, Roberto José Negrão; Chaves, A. Iñigo; Zambrone, Flávio Ailton Duque; Fonseca, Márcia Regina Campos Costa da; Tourinho, Francis Solange Vieira

doi:10.1590/s0036-46651995000400008

Cited by 102 publications

(80 citation statements)

References 35 publications

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“…These fi ndings are in agreement with the correlation between young age and the severity of clinical manifestations after scorpion envenomation found in other studies [28][29][30] . High morbidity and lethality rates in children have usually been associated with immune system vulnerability and the ratio of the dose of the venom to the body weight of the patient 7,31 .…”

Section: Discussionsupporting

confidence: 93%

Pediatric epidemiological aspects of scorpionism and report on fatal cases from Tityus stigmurus stings (Scorpiones: Buthidae) in State of Pernambuco, Brazil

Albuquerque

Neto²,

Amorim³

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction: Envenomation by scorpion stings is a major public health problem in numerous tropical countries because of its frequent incidence and potential severity. Approximately 1,900 species of scorpions are known in the world, and at least 130 of these have been described in Brazil. Methods: This work reports on 3 child deaths caused by Tityus stigmurus stings and characterizes epidemiological and clinical surveys on pediatric cases of scorpionism recorded in the Centro de Assistência Toxicológica de Pernambuco (Ceatox-PE). Results: Scorpion stings accounted for more than 60% of all cases recorded for venomous animals. The children were from 37 cities of the State of Pernambuco and accounted for 28.8% of the victims treated for scorpion stings, with the highest incidence in the metropolitan area of Recife. Stings occurred throughout the year and slightly increased during the rainy season. Independent of the elapsed time for a prognosis, most cases showed mild symptoms. Three moderate cases that resulted in death featured cardiogenic shock and/or pulmonary edema or severe neurological symptoms. For the fi rst time, death attributed to T. stigmurus was confi rmed by the presence of the scorpion. Conclusions: These results suggest that scorpionism in Pernambuco is a public health problem that needs to be monitored carefully throughout the year by the government.

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Section: Discussionsupporting

confidence: 93%

Pediatric epidemiological aspects of scorpionism and report on fatal cases from Tityus stigmurus stings (Scorpiones: Buthidae) in State of Pernambuco, Brazil

Albuquerque

Neto²,

Amorim³

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…Among these, the most important species are T. serrulatus, T. bahiensis, T. stigmurus and T. trivittatus in South America; (2,8,33,36); C. suffusus, C.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of scorpion sting incidence in turkey

Özkan¹,

Uzun²,

Adiguzel³

et al. 2008

J. Venom. Anim. Toxins incl. Trop. Dis

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“…A number of studies have investigated the effect of age on the toxicity of T. serrulatus scorpion venom and other scorpion venoms (2,7,8,13,14). Clot-Faybesse et al (15) showed that 3-7-day-old mice were more susceptible to scorpion neurotoxin than 10-week-old adult mice.…”

Section: Introductionmentioning

confidence: 99%

Age effects on the pharmacokinetics of tityustoxin from Tityus serrulatus scorpion venom in rats

Nunan

Arya

Hochhaus

et al. 2004

Braz J Med Biol Res

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The pharmacokinetics of scorpion venom and its toxins has been investigated in experimental models using adult animals, although, severe scorpion accidents are associated more frequently with children. We compared the effect of age on the pharmacokinetics of tityustoxin, one of the most active principles of Tityus serrulatus venom, in young male/female rats (21-22 days old, N = 5-8) and in adult male rats (150-160 days old, N = 5-8). Tityustoxin (6 µg) labeled with 99m Technetium was administered subcutaneously to young and adult rats. The plasma concentration vs time data were subjected to non-compartmental pharmacokinetic analysis to obtain estimates of various pharmacokinetic parameters such as total body clearance (CL/ F), distribution volume (Vd/F), area under the curve (AUC), and mean residence time. The data were analyzed with and without considering body weight. The data without correction for body weight showed a higher C max (62.30 ± 7.07 vs 12.71 ± 2.11 ng/ml, P < 0.05) and AUC (296.49 ± 21.09 vs 55.96 ± 5.41 ng h -1 ml -1 , P < 0.05) and lower T max (0.64 ± 0.19 vs 2.44 ± 0.49 h, P < 0.05) in young rats. Furthermore, Vd/F (0.15 vs 0.42 l/kg) and CL/F (0.02 ± 0.001 vs 0.11 ± 0.01 l h -1 kg -1 , P < 0.05) were lower in young rats. However, when the data were reanalyzed taking body weight into consideration, the C max (40.43 ± 3.25 vs 78.21 ± 11.23 ng kg -1 ml -1 , P < 0.05) and AUC (182.27 ± 11.74 vs 344.62 ± 32.11 ng h -1 ml -1 , P < 0.05) were lower in young rats. The clearance (0.03 ± 0.002 vs 0.02 ± 0.002 l h -1 kg -1 , P < 0.05) and Vd/F (0.210 vs 0.067 l/kg) were higher in young rats. The raw data (not adjusted for body weight) strongly suggest that age plays a pivotal role in the disposition of tityustoxin. Furthermore, our results also indicate that the differences in the severity of symptoms observed in children and adults after scorpion envenomation can be explained in part by differences in the pharmacokinetics of the toxin.

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A comparative study of severe scorpion envenomation in children caused by Tityus bahiensis and Tityus serrulatus

Cited by 102 publications

References 35 publications

Pediatric epidemiological aspects of scorpionism and report on fatal cases from Tityus stigmurus stings (Scorpiones: Buthidae) in State of Pernambuco, Brazil

Pediatric epidemiological aspects of scorpionism and report on fatal cases from Tityus stigmurus stings (Scorpiones: Buthidae) in State of Pernambuco, Brazil

Evaluation of scorpion sting incidence in turkey

Age effects on the pharmacokinetics of tityustoxin from Tityus serrulatus scorpion venom in rats

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