Hematologic Effects and Complications of Snake Envenoming

Berling, Ingrid; Isbister, Geoffrey K.

doi:10.1016/j.tmrv.2014.09.005

Cited by 121 publications

(127 citation statements)

References 43 publications

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“…However, this parameter was not assessed in the current study, since none of the patients had clinical signs of VICC and there were no indications for detailed blood clotting tests. Blood clotting disorders are reported as one of the consequences of V. berus bite; however, they are probably not common [8,10]. No report was found in the literature which focused on this subject.…”

Section: Discussionmentioning

confidence: 99%

“…Factor activators lead to factor depletion and deficiencies, while TLE's and fibrinogenases cleave fibrinogen without forming fibrin, causing a low to undetectable blood fibrinogen concentration. Diagnosis of VICC is performed by measuring clotting times, most commonly prothrombin (PT), partial thromboplastin time (PTT), and the international normalized ratio (INR) [7,8]. VICC describes coagulopathies; however, it is not synonymous with disseminated intravascular coagulation (DIC).…”

Section: Introductionmentioning

confidence: 99%

“…Bleeding severity has a wide range, from local bleeding to life-threatening intracranial or multi-organ haemorrhaging. [8].…”

Section: Introductionmentioning

confidence: 99%

“…Blood test findings can include abnormal INR or PT, low fibrinogen or elevated D-Dimer levels. Fibrinogen is the most commonly consumed clotting factor in snake bites [8]. The above observations apply mainly to tropical snakes, including the viperous species.…”

Section: Introductionmentioning

confidence: 99%

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Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study

Dyląg-Trojanowska¹,

Hodorowicz-Zaniewska

Zybaczynska

et al. 2018

Ann Agric Environ Med.

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Introduction. The Vipera berus (common viper) is the only species of venomous snake found in Poland. The aim of this study was to determine to what extent coagulopathy has occurred as a post-bite complication. Materials and method. The medical records of 138 adult patients in the Sucha Beskidzka hospital with the diagnosis of snake bite between 2001-2014 were retrospectively analyzed. Demographic, clinical and laboratory data were collected. Antivenom was given to all patients, except one, with snake bites, but laboratory test were taken prior to administration of antivenom. Obtained results were compared to those of the control group, composed of 176 adults hospitalized in the same period for an elective laparoscopic cholecystectomy. Results. The mean platelet count in the study group was 239.94×109/L (SD=56.56) and 248.77×109/L (SD=57.82) in the control group. In 98% of the study group and 100% of the control group the platelet value (PLT) fell within laboratory norms (130 to 420×109/L), 2 patients after snake bites had a PLT lower than normal, and thrombocytosis was not observed in either group. A reference range of 0.85-1.3 INR below normal was found in 2 patients in the study group and 15 from the control group, while values above the normal range were found in 8 patients (6.7%) from the snake bite group and no patients from the control group. In the study group, the INR ranged from 0.78-1.43 with a mean of 1.046 (SD=0.14), while in the control group the range was from 0.79-1.28, with a mean of 0.95 (SD=0.08). There was a significant difference in INR between the study and control groups (p<0.0001). Conclusions. The bite from V. berus does not result in severe thrombocytopenia, with only a moderate increase in INR values observed in about 7% of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Bleeding severity has a wide range, from local bleeding to life-threatening intracranial or multi-organ haemorrhaging. [8].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study

Dyląg-Trojanowska¹,

Hodorowicz-Zaniewska

Zybaczynska

et al. 2018

Ann Agric Environ Med.

View full text Add to dashboard Cite

show abstract

“…Venom-induced consumption coagulopathy is the most common snake envenoming syndrome worldwide, occurring with many vipers as well as Australasian elapids (Berling and Isbister, 2015;Maduwage and Isbister, 2014). Venom-induced consumption coagulopathy is defined as the presence of a consumption coagulopathy, resulting in an unrecordable international normalised ratio (INR)/prothrombin time (PT), low or undetectable fibrinogen and elevated D-dimers (>10 times the upper limit of normal) .…”

Section: Introductionmentioning

confidence: 99%