Acidente crotálico na infância: aspectos clínicos, laboratoriais, epidemiológicos e abordagem terapêutica

Cupo, Palmira; Marques, Marisa M. Azevedo; Hering, Sylvia Evelyn

doi:10.1590/s0037-86821991000200004

Cited by 24 publications

(38 citation statements)

References 28 publications

(1 reference statement)

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“…It is well known from experimental and clinical data that the Cdt venom causes impairment of kidney function and renal failure [12,31,36,38]. Despite the expected uremia, the venom did not increase the hepatic production of urea.…”

Section: Discussionmentioning

confidence: 83%

Effects of the crotalus durissus terrificus snake venom on hepatic metabolism and oxidative stress

Silva

Soley

Gris

et al. 2010

J Biochem & Molecular Tox

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Snake venoms present different action mechanisms because of their complex composition, represented mainly by toxins and enzymes. This work aimed to investigate the effects of the Crotalus durissus terrificus(Cdt) venom in the liver. Wistar rats were inoculated intraperitoneally with saline (control) or Cdt venom. After 3, 4, or 6 h, the following parameters were analyzed: (a) hepatic function, (b) oxidative stress parameters, and (c) the metabolism of alanine in the isolated perfused liver. Plasma activities of alanine aminotransferase and aspartate aminotransferase and hepatic glutathione S-transferase and catalase presented significant elevation in rats inoculated with 300 μg ⋅ kg(-1) Cdt venom. Liver lipoperoxidation was enormously increased by venom doses of 100, 200, and 300 μg ⋅kg(-1) , whereas glutathione S-transferase was not changed. Perfused livers from rats inoculated with 1500 μg ⋅kg(-1) venom showed increased production of lactate, pyruvate, and ammonia when alanine was the metabolic substrate. These results demonstrate that the Cdt venom can produce several changes in hepatocytes. The causes of the changes are possibly related to the disequilibrium in the redox homeostasis but also to specific needs of the poisoned organism, for example, an increased supply of lactate and pyruvate in response to an increased activity of the Cori cycle.

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Section: Discussionmentioning

confidence: 83%

Effects of the crotalus durissus terrificus snake venom on hepatic metabolism and oxidative stress

Silva

Soley

Gris

et al. 2010

J Biochem & Molecular Tox

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“…Twenty-one percent of snakebites in Brazil occur in patients under 15 years old 4 . However, only two studies, published by the same authors, have described the clinical and laboratory aspects of C. d. terrificus snakebites in a case series of children (10 to 21 patients) in Brazil 9,11 . The present report describes the clinical and some laboratory aspects of bites caused by C. durissus ssp in 31 children less than 15 y old admitted to the University Hospital of the State University of Campinas (UNICAMP) in Campinas, São Paulo state.…”

Section: Introductionmentioning

confidence: 99%

Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil

Bucaretchi

Herrera

Hyslop

et al. 2002

Rev. Inst. Med. trop. S. Paulo

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From January, 1984 to March, 1999, 31 children under 15 y old (ages 1-14 y, median 8 y) were admitted after being bitten by rattlesnakes (Crotalus durissus ssp). One patient was classified as "dry-bite", 3 as mild envenoming, 9 as moderate envenoming and 18 as severe envenoming. Most patients had neuromuscular manifestations, such as palpebral ptosis (27/31), myalgia (23/31) and weakness (20/31). Laboratory tests suggesting rhabdomyolysis included an increase in total blood creatine kinase (CK, 28/29) and lactate dehydrogenase (LDH, 25/25) levels and myoglobinuria (14/15). The main local signs and symptoms were slight edema (20/31) and erythema (19/31). Before antivenom (AV) administration, blood coagulation disorders were observed in 20/25 children that received AV only at our hospital (incoagulable blood in 17/25). AV early reactions were observed in 20 of these 25 cases (9/9 patients not pretreated and 11/16 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). There were no significant differences in the frequency of patients with AV early reactions between the groups that were and were not pretreated (Fisher's exact test, p = 0.12). Patients admitted less than and more than 6 h after the bite showed the same risk of developing severe envenoming (Fisher's exact test, p = 1). No children of the first group (< 6 h) showed severe complications whereas 3/6 children admitted more than 6 h post-bite developed acute renal failure. Patients bitten in the legs had a higher risk of developing severe envenoming (Fisher's exact test, p = 0.04). There was a significant association between both total CK and LDH blood enzyme levels and severity (p < 0.001 for CK and p < 0.001 for LDH; Mann-Whitney U test). No deaths were recorded.

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“…In Latin America, snake bite envenomation constitutes a relevant public health problem where most accidents are due to species of the genus Bothrops, although envenomations by Crotalus spp. also occurs, particularly in South America, where they are usually associated with severe systemic envenomations (Rosenfeld, 1971;Kamiguti and Cardoso, 1989;Cupo et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Anti‐snake venom properties of Schizolobium parahyba (Caesalpinoideae) aqueous leaves extract

Mendes

Oliveira

Lopes

et al. 2008

Phytotherapy Research

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Many medicinal plants have been recommended for the treatment of snakebites. The aqueous extracts prepared from the leaves of Schizolobium parahyba (a plant found in Mata Atlantica in Southeastern Brazil) were assayed for their ability to inhibit some enzymatic and biological activities induced by Bothrops pauloensis and Crotalus durissus terrificus venoms as well as by their isolated toxins neuwiedase (metalloproteinase), BnSP-7 (basic Lys49 PLA(2)) and CB (PLA(2) from crotoxin complex). Phospholipase A(2), coagulant, fibrinogenolytic, hemorrhagic and myotoxic activities induced by B. pauloensis and C. d. terrificus venoms, as well as by their isolated toxins were significantly inhibited when different amounts of S. parahyba were incubated previously with these venoms and toxins before assays. However, when S. parahyba was administered at the same route as the venoms or toxins injections, the tissue local damage, such as hemorrhage and myotoxicity was only partially inhibited. The study also evaluated the inhibitory effect of S. parahyba upon the spreading of venom proteins from the injected area into the systemic circulation. The neutralization of systemic alterations induced by i.m. injection of B. pauloensis venom was evaluated by measuring platelet and plasma fibrinogen levels which were significantly maintained when S. parahyba extract inoculation occurred at the same route after B. pauloensis venom injection. In conclusion, the observations confirmed that the aqueous extract of S. parahyba possesses potent snake venom neutralizing properties. It may be used as an alternative treatment to serum therapy and as a rich source of potential inhibitors of toxins involved in several physiopathological human and animal diseases.

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Acidente crotálico na infância: aspectos clínicos, laboratoriais, epidemiológicos e abordagem terapêutica

Cited by 24 publications

References 28 publications

Effects of the crotalus durissus terrificus snake venom on hepatic metabolism and oxidative stress

Effects of the crotalus durissus terrificus snake venom on hepatic metabolism and oxidative stress

Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil

Anti‐snake venom properties of Schizolobium parahyba (Caesalpinoideae) aqueous leaves extract

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