Hemorrhagic stroke secondary to Bothrops spp. venom: A case report

Delgado, Anna Beatriz Temoteo; Gondim, Caio Cesar Vaz Lacet; Reichert, Lucas Pereira; Silva, Pedro Hugo Vieira da; Souza, Rodrigo Marmo da Costa e; Fernandes, Thiago Monteiro de Paiva; Calvo, Bernardino Fernandez

doi:10.1016/j.toxicon.2017.03.015

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Visceral hemorrhages are less frequent but more severe and may include hemarthrosis (finger joints, knee) [16], hepatic or retroperitoneal hematoma [16,35], hemothorax [32,36], pulmonary hemorrhage [37], hematemesis and rectal bleeding [28,29]. Central nervous system hemorrhages are a dreadful complication and may be intracerebral, intraventricular, subarachnoid, subdural, extradural, cerebellar or medullar [16,38,39]. In a study on the prevalence of cerebrovascular complications in Bothrops envenoming, it was found that 2.6% of the victims developed a cerebrovascular event, of which about 60% died and 40% remained with sequelae [40].…”

Section: Systemic Hemorrhagementioning

confidence: 99%

Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders

Larréché

Chippaux

Chevillard

et al. 2021

IJMS

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Toxins from Bothrops venoms targeting hemostasis are responsible for a broad range of clinical and biological syndromes including local and systemic bleeding, incoagulability, thrombotic microangiopathy and macrothrombosis. Beyond hemostais disorders, toxins are also involved in the pathogenesis of edema and in most complications such as hypovolemia, cardiovascular collapse, acute kidney injury, myonecrosis, compartmental syndrome and superinfection. These toxins can be classified as enzymatic proteins (snake venom metalloproteinases, snake venom serine proteases, phospholipases A2 and L-amino acid oxidases) and non-enzymatic proteins (desintegrins and C-type lectin proteins). Bleeding is due to a multifocal toxicity targeting vessels, platelets and coagulation factors. Vessel damage due to the degradation of basement membrane and the subsequent disruption of endothelial cell integrity under hydrostatic pressure and tangential shear stress is primarily responsible for bleeding. Hemorrhage is promoted by thrombocytopenia, platelet hypoaggregation, consumption coagulopathy and fibrin(ogen)olysis. Onset of thrombotic microangiopathy is probably due to the switch of endothelium to a prothrombotic phenotype with overexpression of tissue factor and other pro-aggregating biomarkers in association with activation of platelets and coagulation. Thrombosis involving large-caliber vessels in B. lanceolatus envenomation remains a unique entity, which exact pathophysiology remains poorly understood.

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Section: Systemic Hemorrhagementioning

confidence: 99%

Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders

Larréché

Chippaux

Chevillard

et al. 2021

IJMS

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“…Humans have been engaged in agricultural activities such as planting crops and raising animals since the Paleolithic era (12 000 to 5 000 years BP), which continued over the millennia to the present day [72][73][74] . Many people do this job and find themselves vulnerable to venomous snakebites [75][76][77] . According to Suazo-Ortuño et al 78 research on agricultural conversion, snakes are not susceptible to changes in their habitat; the species diversity in agricultural areas is not diminished, and snakebites risk is maintained.…”

Section: Snakebite In the Neotropics: Ecological And Environmental As...mentioning

confidence: 99%

Current situation of snakebites envenomation in the Neotropics: Biotechnology, a versatile tool in the production of antivenoms.

Romo

Arias

Martin-Solano

2022

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Snakebite envenomation is a neglected tropical disease that affects millions of people around the world with a great impact on health and the economy. Unfortunately, public health programs do not include this kind of disease as a priority in their social programs. Cases of snakebite envenomations in the Neotropics are inaccurate due to inadequate disease management from medical records to the choice of treatments. Victims of snakebite envenomation are primarily found in impoverished agricultural areas where remote conditions limit the availability of antivenom. Antivenom serum is the only Food and Drug Administration-approved treatment used up to date. However, it has several disadvantages in terms of safety and effectiveness. This review provides a comprehensive insight dealing with the current epidemiological status of snakebites in the Neotropics and technologies employed in antivenom production. Also, modern biotechnological tools such as transcriptomic, proteomic, immunogenic, high-density peptide microarray and epitope mapping are highlighted for producing new-generation antivenom sera. These results allow us to propose strategic solutions in the Public Health Sector for managing this disease. Keywords: antivenom, biotechnology, neglected tropical disease, omics, recombinant antibody.

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“…Although regarded as a secondary cause of acquired hemostatic disorders in hemostasis textbooks, bleedings evoked by snakebite envenomation are particularly common in patients from low-income tropical countries [3], leading to severe or fatal outcomes, e.g. life-threatening hemorrhage [4,5], intracranial hemorrhage [6,7], and spontaneous abortion in women [8].…”

Section: Introductionmentioning

confidence: 99%

Liver gene regulation of hemostasis-related factors is altered by experimental snake envenomation in mice

2020

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Few studies have addressed gene expression of hemostasis-related factors during acute thrombo-hemorrhagic diseases. Bites by the lanced-headed viper Bothrops jaracaca induce rapid hemostatic disturbances in victims, leading to systemic bleedings, thrombocytopenia and consumption coagulopathy. Although circulating levels of coagulation factors recover rapidly after administration of specific antivenom therapy, it is unclear if B. jararaca venom (BjV) upregulates the mRNA synthesis of hepatic hemostasis-related factors, or if the recovery occurs under basal conditions after the neutralization of venom components by antivenom. Thus, we aimed to investigate if BjV regulates gene expression of important hemostasis-related factors synthetized by the liver. On that account, Swiss mice were injected with saline or BjV (1.6 mg/kg b.w, s.c.), and after 3, 6 and 24 h blood samples and liver fragments were collected to analyze mRNA expression by real-time qPCR. Increased gene expression of fibrinogen chains, haptoglobin and STAT3 was observed during envenomation, particularly at 3 and 6 h. At 24h, mRNA levels of F10 were raised, while those of Serpinc1, Proc and Adamts13 were diminished. Surprisingly, F3 mRNA levels were steadily decreased at 3 h. Gene expression of Thpo, F7, F5 Tfpi, Mug1 was unaltered. mRNA levels of Vwf, P4hb, F8, F2, Plg, and Serpinf2 were minimally altered, but showed important associations with Nfkb1 gene expression. In conclusion, snakebite envenomation upregulates hepatic mRNA synthesis particularly of fibrinogen chains, and acute-phase markers. This response explains the fast recovery of fibrinogen levels after antivenom administration to patients bitten by B. jararaca snakes.

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Hemorrhagic stroke secondary to Bothrops spp. venom: A case report

Cited by 6 publications

References 13 publications

Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders

Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders

Current situation of snakebites envenomation in the Neotropics: Biotechnology, a versatile tool in the production of antivenoms.

Liver gene regulation of hemostasis-related factors is altered by experimental snake envenomation in mice

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