Haematological evaluation of patients bitten by the jararaca, Bothrops jararaca, in Brazil

Santoro, Marcelo Larami; Sano-Martins, Ida Sigueko; Fan, Hui Wen; Cardoso, João Luiz Costa; Theakston, R.D.G.; Warrell, David A.

doi:10.1016/j.toxicon.2008.03.018

Cited by 83 publications

(93 citation statements)

References 45 publications

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“…Leukocytosis with neutrophilia that was observed in groups VS and VSM at M1 and M2 in this study, together with lymphopenia at M2 and M3 in both groups, are consistent with other authors, and this may be due to inflammatory processes and stress caused by general pain (Santoro et al 2008, Ferreira Junior & Barraviera 2004.…”

Section: Discussionsupporting

confidence: 93%

Effect of Mikania glomerata (Asteraceae) leaf extract combined with anti-venom serum on experimental Crotalus durissus (Squamata: Viperidae) envenomation in rats

Floriano

Nogueira

Sakate³

et al. 2009

RBT

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Abstract:Crotalic envenomation represents the highest number of deaths when compared to other snakebite envenomations of medical interest. Crotalic venom has important characteristics such as neurotoxicity, myotoxicity, nephrotoxicity, and clotting and hemolytic action. We evaluated the clinical and laboratory aspects of Crotalus durissus terrificus experimental envenomation in Wistar rats treated with antivenom and the aqueous extract of the plant Mikania glomerata. The animals were divided into three groups: Group C (control); Group VS-venom and antivenom; Group VSM-venom, antivenom and aqueous extract of M. glomerata. Crotalic poison caused clinical and laboratory alterations in Wistar mice. Significant clinical alterations were: temperature decrease, edema in the venom inoculated member, sedation and a locomotion decrease in groups VS and VSM when compared with group C. A faster recovery from sedation was observed only for animals of group VSM when compared to VS. There was an increase in the number of leukocytes, neutrophils and creatine kinase in the VS and VSM groups, compared to group C. Wistar rats showed a high resistance to crotalic venom. Additional studies with different doses, time of treatment, different administration methods and histopathological and immunological studies are necessary to understand the action of M. glomerata in crotalic accidents. Rev. Biol. Trop. 57 (4): 929-937. Epub 2009 December 01.

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Section: Discussionsupporting

confidence: 93%

Effect of Mikania glomerata (Asteraceae) leaf extract combined with anti-venom serum on experimental Crotalus durissus (Squamata: Viperidae) envenomation in rats

Floriano

Nogueira

Sakate³

et al. 2009

RBT

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“…A significant association was determined between gingival bleeding and abnormal blood coagulability. A study conducted in the HVB between 1989 and 1991, involving 100 patients bitten by Bothropoides jararaca, observed that patients with systemic bleeding upon hospital admission presented thrombocytopenia 31 . In contrast, patients with local bleeding had identical platelet counts compared to patients without bleeding.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, patients with local bleeding had identical platelet counts compared to patients without bleeding. The authors concluded that thrombocytopenia at admission is associated with the development of systemic bleeding and the severity of the accident 31 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of Bothropoides jararaca bites with and without envenoming treated at the Vital Brazil Hospital of the Butantan Institute, State of São Paulo, Brazil

Nicoleti

Medeiros

Duarte

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: This study analyses the cases of all bites (including dry bites) caused by Bothropoides jararaca attended at the Vital Brazil Hospital of the Butantan Institute, State of São Paulo, Brazil. Methods: A retrospective study was conducted of patients bitten by Bothropoides jararaca (n=792) from January 1990 to December 2004. The characteristics of the snake specimen, data related to the accident and clinical manifestations on admission were obtained from patient medical records. Results: The majority of the cases in this study were caused by female and juvenile snakes. No stomach contents were found in 93.4% of the snake specimens after dissection. No statistical difference was observed between the occurrence of dry bites and the maturity or sex of the snake. The median SVL of snakes in mild and moderate cases was 40.5cm and in severe cases, SVL increased to 99cm. Necrosis was more common in the digits of the feet and hands (4.8%) compared to the other body regions (1.8%). A significant difference was verified between severity and a time interval greater than six hours from the bite to hospital admission. A significant association was verified between gingival bleeding and abnormal blood coagulability. In accidents caused by adult snakes, necrosis was more frequent (7.2%) compared to accidents caused by juvenile snakes (1%). Conclusions: In this work, the association between certain epidemiological data and the evolution of biological parameters in the clinical course of Bothrops sensu latu accidents were highlighted, contributing to the improvement of snake bite assistance.

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“…instead of warfarin, and injected with BjV; group War þ Sal: in this group, a control of the warfarin treatment, rats were warfarinized and injected with saline; group Sal þ Sal, animals were pretreated and inoculated with saline solution, under the same conditions reported earlier. At 3,6, or 24 h after venom or saline injection, rats were anesthetized, and blood samples were obtained by puncture of abdominal aorta and immediately dispensed in plastic bottles containing anticoagulants. Anesthetized rats were exsanguinated and immediately euthanized following blood collection.…”

Section: In Vivo Experimentsmentioning

confidence: 99%

Bothrops jararaca envenomation: Pathogenesis of hemostatic disturbances and intravascular hemolysis

Senise

Yamashita

Santoro

2015

Exp Biol Med (Maywood)

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To attain fully functional biological activity, vitamin-K dependent coagulation factors (VKDCF) are g-carboxylated prior to secretion from liver. Warfarin impairs the g-carboxylation, and consequently their physiological function. Bothrops jararaca snake venom (BjV) contains several activators of blood coagulation, especially procoagulant enzymes (prothrombin and factor X activators) and thrombin-like enzymes. In order to clarify the relative contribution of prothrombin and factor X activators to the hemostatic disturbances occurring during experimental B. jararaca envenomation, warfarin was used to deplete VKDCF, prior to BjV administration. Male Wistar rats were pretreated with saline (Sal) or warfarin (War) and inoculated subsequently with BjV or saline, thus forming four groups: Sal þ Sal (negative control), Sal þ BjV (positive control), War þ Sal (warfarinization control), and War þ BjV. Three hours after inoculation, prothrombin and factor X levels fell 40% and 50%, respectively; levels of both factors decreased more than 97% in the War þ Sal and War þ BjV groups. Platelet counts dropped 93% and 76% in Sal þ BjV and War þ BjV, respectively, and plasma fibrinogen levels decreased 86% exclusively in Sal þ BjV. After 6 and 24 h, platelet counts and fibrinogen levels increased progressively. A dramatic augmentation in plasma hemoglobin levels and the presence of schizocytes and microcytes in the Sal þ BjV group indicated the development of intravascular hemolysis, which was prevented by warfarin pretreatment. Our findings show that intravascular thrombin generation has the foremost role in the pathogenesis of coagulopathy and intravascular hemolysis, but not in the development of thrombocytopenia, in B. jararaca envenomation in rats; in addition, fibrinogenases (metalloproteinases) may contribute to coagulopathy more than thrombin-like enzymes.

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Haematological evaluation of patients bitten by the jararaca, Bothrops jararaca, in Brazil

Cited by 83 publications

References 45 publications

Effect of Mikania glomerata (Asteraceae) leaf extract combined with anti-venom serum on experimental Crotalus durissus (Squamata: Viperidae) envenomation in rats

Effect of Mikania glomerata (Asteraceae) leaf extract combined with anti-venom serum on experimental Crotalus durissus (Squamata: Viperidae) envenomation in rats

Comparison of Bothropoides jararaca bites with and without envenoming treated at the Vital Brazil Hospital of the Butantan Institute, State of São Paulo, Brazil

Bothrops jararaca envenomation: Pathogenesis of hemostatic disturbances and intravascular hemolysis

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