Embolie pulmonaire dans les suites d’une envenimation grave par une vipère marocaine

Chani, M.; Abouzahir, A.; Larréché, Sébastien; Mion, G.

doi:10.1007/s13149-012-0248-7

Cited by 11 publications

(3 citation statements)

References 12 publications

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“…However, the reports on pulmonary embolism following SBE are poorly reported. Some studies have reported the occurrence of pulmonary embolism in severe envenomation by Crotalus scutulatus [22], Moroccan viper [23], Bothrops lanceolatus [30], and unknown viper species in France [21] and Greece [31]. To our knowledge, this manifestation has not been previously documented in victims following Russell's viper envenomation.…”

Section: Discussionmentioning

confidence: 67%

“…There are several pathological conditions and risk factors associated with this condition such as prolonged inactivity and vasculature damage that can induce deep vein thrombosis and subsequent embolism [20]. Indeed, SBE has been reported to induce pulmonary embolism in a few cases [21][22][23], although Russell's viper bite-induced thromboembolism has been poorly reported. The non-specific nature of clinical manifestations for pulmonary thromboembolism often affects prompt diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Thromboembolism following Russell’s Viper Bites

Senthilkumaran,

Sampath,

Almeida

et al. 2024

Toxins

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Snakebite envenoming and its resulting complications are serious threats to the health of vulnerable people living in rural areas of developing countries. The knowledge of the heterogeneity of symptoms associated with snakebite envenoming and their management strategies is vital to treat such life-threatening complications to save lives. Russell’s viper envenomation induces a diverse range of clinical manifestations from commonly recognised haemotoxic and local effects to several rare conditions that are often not reported. The lack of awareness about these unusual manifestations can affect prompt diagnosis, appropriate therapeutic approaches, and positive outcomes for patients. Here, we report pulmonary thromboembolism that developed in three patients following Russell’s viper envenomation and demonstrate their common clinical features and diagnostic and therapeutic approaches used. All patients showed clinical signs of local (oedema) and systemic (blood coagulation disturbances) envenomation, which were treated using polyvalent antivenom. They exhibited elevated heart rates, breathlessness, and reduced oxygen saturation, which are non-specific but core parameters in the diagnosis of pulmonary embolism. The recognition of pulmonary embolism was also achieved by an electrocardiogram, which showed sinus tachycardia and computed tomography and echocardiogram scans further confirmed this condition. Anti-coagulant treatment using low-molecular-weight heparin offered clinical benefits in these patients. In summary, this report reinforces the broad spectrum of previously unreported consequences of Russell’s viper envenomation. The constant updating of healthcare professionals and the dissemination of major lessons learned in the clinical management of snakebite envenoming through scientific documentation and educational programs are necessary to mitigate the adverse impacts of venomous snakebites in vulnerable communities.

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Pulmonary Thromboembolism following Russell’s Viper Bites

Senthilkumaran,

Sampath,

Almeida

et al. 2024

Toxins

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“…There have been scarce reports of cases with thrombosis as a consequence of viperid snakebites. 34 35 36 An exception to this trend of the low frequency of thrombotic phenomena in SBE is the envenoming by Bothrops lanceolatus , an endemic species in the Caribbean Island of Martinique. A significant proportion of patients bitten by this species develop thrombotic complications associated with infarctions in the lungs, heart, and brain 24 37 ; however, no effects on limbs were reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Arterial Thrombosis following Russell's Viper Bites

Patel

Rajan

Vijayakumar

et al. 2023

TH Open

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Envenomings by Russell's viper (Daboia russelii), a species of high medical importance in India and other Asian countries, commonly result in hemorrhage, coagulopathies, necrosis, and acute kidney injury. Although bleeding complications are frequently reported following viper envenomings, thrombotic events occur rarely (reported only in coronary and carotid arteries) with serious consequences. For the first time, we report three serious cases of peripheral arterial thrombosis following Russell's viper bites and their diagnostic, clinical management, and mechanistic insights. These patients developed occlusive thrombi in their peripheral arteries and symptoms despite antivenom treatment. In addition to clinical features, computed tomography angiography was used to diagnose arterial thrombosis and ascertain its precise locations. They were treated using thrombectomy or amputation in one case that presented with gangrenous digits. Mechanistic insights into the pathology through investigations revealed the procoagulant actions of Russell's viper venom in standard clotting tests as well as in rotational thromboelastometry analysis. Notably, Russell's viper venom inhibited agonist-induced platelet activation. The procoagulant effects of Russell's viper venom were inhibited by a matrix metalloprotease inhibitor, marimastat, although a phospholipase A2 inhibitor (varespladib) did not show any inhibitory effects. Russell's viper venom induced pulmonary thrombosis when injected intravenously in mice and thrombi in the microvasculature and affected skeletal muscle when administered locally. These data emphasize the significance of peripheral arterial thrombosis in snakebite victims and provide awareness, mechanisms, and robust strategies for clinicians to tackle this issue in patients.

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Exotic Envenomation in the United States

Seifert

2016

Clinical Toxinology

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Embolie pulmonaire dans les suites d’une envenimation grave par une vipère marocaine

Cited by 11 publications

References 12 publications

Pulmonary Thromboembolism following Russell’s Viper Bites

Pulmonary Thromboembolism following Russell’s Viper Bites

Peripheral Arterial Thrombosis following Russell's Viper Bites

Exotic Envenomation in the United States

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