Severe Lung Oedema and Fatal Consumption Coagulopathy after Funnel‐Web Bite

Torda, T. A.; Loong, E. D.; Greaves, Ian

doi:10.5694/j.1326-5377.1980.tb131914.x

Cited by 28 publications

(21 citation statements)

References 7 publications

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“… 16 from the previously published prospective study; 6 89 from records of specimens at the Australian Museum (64), Queensland Museum (16), Tasmanian Museum (8) and Museum Victoria (1); 43 from the MEDLINE and EMBASE searches (13 case reports and series 3 , 4 , 6 ‐ 8 , 12 ‐ 19 in 185 publications) and from reference lists and textbooks (a further 12 reports 5 , 20 ‐ 29 ). 50 from other sources: CSL antivenom reports (14), NSW Poisons Information Centre (9); the media (6); Hunter Area Toxicology Service (5); ongoing national prospective study of snake and spider envenoming (3) and other reports from authors (13). …”

Section: Resultsmentioning

confidence: 99%

Funnel‐web spider bite: a systematic review of recorded clinical cases

Isbister

Gray

Balit³

et al. 2005

Medical Journal of Australia

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Objective: To investigate species‐specific envenoming rates and spectrum of severity of funnel‐web spider bites, and the efficacy and adverse effects of funnel‐web spider antivenom. Data sources: Cases were identified from a prospective study of spider bite presenting to four major hospitals and three state poisons information centres (1999–2003); museum records of spider specimens since 1926; NSW Poisons Information Centre database; MEDLINE and EMBASE search; clinical toxinology textbooks; the media; and the manufacturer's reports of antivenom use. Data extraction: Patient age and sex, geographical location, month, expert identification of the spider, clinical effects and management; envenoming was classified as severe, mild–moderate or minor/local effects. Data synthesis: 198 potential funnel‐web spider bites were identified: 138 were definite (spider expertly identified to species or genus), and 77 produced severe envenoming. All species‐identified severe cases were attributed to one of six species restricted to NSW and southern Queensland. Rates of severe envenoming were: Hadronyche cerberea (75%), H. formidabilis (63%), Atrax robustus (17%), Hadronyche sp. 14 (17%), H. infensa (14%) and H. versuta (11%). Antivenom was used in 75 patients, including 22 children (median dose, 3 ampoules; range, 1–17), with a complete response in 97% of expertly identified cases. Three adverse reactions were reported, all in adults: two early allergic reactions (one mild and one with severe systemic effects requiring adrenaline), and one case of serum sickness. Conclusions: Severe funnel‐web spider envenoming is confined to NSW and southern Queensland; tree‐dwelling funnel webs (H. cerberea and H. formidabilis) have the highest envenoming rates. Funnel‐web spider antivenom appears effective and safe; severe allergic reactions are uncommon.

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Section: Resultsmentioning

confidence: 99%

Funnel‐web spider bite: a systematic review of recorded clinical cases

Isbister

Gray

Balit³

et al. 2005

Medical Journal of Australia

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“…A, robustus venom has long been known to have strong actions on systemic blood pressure (Sutherland, 1978) and on individual blood vessels (Morgans and Carroll, 1976). Changes in perfusion pressures in envenomated capillary beds may therefore be at least a minor reason why Atrax venoms cause oedema, although Torda et aL (1980) concluded that the pulmonary oedema seen in at least one human funnei-web victim was non-cardiogenic in origin. Jancso et aL (1967) divided inflammatory agents into those that directly increase capillary permeability and those that have an indirect, neurogenic action.…”

Section: Discussionmentioning

confidence: 99%

“…The most obvious effects caused by the venoms of the various species of funnel-web spiders in susceptible animals are known to be due to neuromuscular activation by a venom component with neurotoxic actions (Sutherland, 1978;Mylecharane, Spence and Gregson, 1984;Sheumack et al, 1984). However, it has been reported that another common feature of funnelweb envenomation is oedema (Wiener, 1961;Torda, Loong and Greaves, 1980). By measuring the extent of swelling of rat paws after injection of venom, Sheumack et al (1984) obtained evidence that the venom component responsible for the oedema induced by Atrax robustus venom is not its neurotoxin.…”

Section: Introductionmentioning

confidence: 99%

“…The research reported in this paper was initiated because it was felt that the information presently available in the literature did not adequately explain the known pattern of induction of oedema by funnel-web venom. Duffield et al (1979) could find only a small amount of 5-hydroxytryptamine in male funnel-web venom and traces of 5-methoxytryptamine in female venom, yet the 2-4 fi\ Of raw venom typically obtained from a male funnel-web in one milkmg (Atkmson, 1981a) is apparently sufficient to cause severe pulmonary oedema even after dilution in the entire extra-ceilular fluid volume of a human victim (Wiener, 1961;Torda et aL, 1980).…”

Section: Introductionmentioning

confidence: 99%

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SOME STUDIES OF THE OEDEMATOGENIC ACTION OF THE VENOM OF FUNNEL‐WEB SPIDERS (ATRAX SPECIES)

Atkinson

1986

Aust J Exp Biol Med

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Summary. The ability of the venoms of Atrax infensus and two other funnel-web spider species to induce oedema in rats was investigated and it was found that all Atrax venoms tested caused strong Evans blue leakage from adjacent blood vessels when injected subcutaneously. This dye leakage did not diminish significantly either when the neurotoxin in the venom was first neutralized by pre-mixing with a rat serum protein preparation or when the sensory nerves supplying an area of skin were severed 4 days prior to its envenomation. The pattern and speed of Evans blue extravasation caused by female A. infensus venom resembled that for histamine and for 5-hydroxytryptamine, and pretreatment with an antihistamine-antiserotonin mixture caused essentially complete blockade of the oedematogenic action of this venom, although neither inhibitory drug was very effective when used individually. It was concluded that this venom induces local oedema in rats mainly by causing mast cell degranulation. In confirmation of this, the mast cells in the rat skull periosteal membranes were found to be extensively degranulated by exposure to the venom. Surprisingly, whole-rat envenomation, using very large doses of venom, produced little dye leakage even though obvious symptoms of neurotoxic action were observed.

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“…Early symptoms of systemic envenomation include perioral tingling, tongue and facial muscle fasciculation, nausea, vomiting, profuse sweating, salivation, lachrymation and dyspnoea 42 . Patients may rapidly develop confusion, agitation and coma associated with marked hypertension, metabolic acidosis, raised intracranial pressure, mydriasis, generalized muscle fasciculations and non‐cardiogenic pulmonary oedema 43 . Children may deteriorate rapidly and death may result in 1–2 h if left untreated 42 .…”

Section: Australian Funnel‐web Spidersmentioning

confidence: 99%

Spiders of medical importance in the Asia–Pacific: Atracotoxin, latrotoxin and related spider neurotoxins

Nicholson

Graudins

2002

Clin Exp Pharma Physio

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1. The spiders of medical importance in the Asia-Pacific region include widow (family Theridiidae) and Australian funnel-web spiders (subfamily Atracinae). In addition, cupboard (family Theridiidae) and Australian mouse spiders (family Actinopodidae) may contain neurotoxins responsible for serious systemic envenomation. Fortunately, there appears to be extensive cross-reactivity of species-specific widow spider antivenom within the family Theridiidae. Moreover, Sydney funnel-web antivenom has been shown to be effective in the treatment of mouse spider envenomation. 2. alpha-Latrotoxin (alpha-LTx) appears to be the main neurotoxin responsible for the envenomation syndrome known as "latrodectism" following bites from widow spiders. This 120 kDa protein binds to distinct receptors (latrophilin 1 and neurexins) to induce neurotransmitter vesicle exocytosis via both Ca2+-dependent and -independent mechanisms, resulting in vesicle depletion. This appears to involve disruption to a process that normally inhibits vesicle fusion in the absence of Ca2+. Precise elucidation of the mechanism of action of alpha-LTx will lead to a major advancement in our understanding of vesicle exocytosis. 3. delta-Atracotoxins (delta-ACTX) are responsible for the primate-specific envenomation syndrome seen following funnel-web spider envenomation. These peptides induce spontaneous repetitive firing and prolongation of action potentials in excitable cells. This results from a hyperpolarizing shift of the voltage-dependence of activation and a slowing of voltage-gated Na+ channel inactivation. This action is due to voltage-dependent binding to neurotoxin receptor site-3 on insect and mammalian voltage-gated Na+ channels in a manner similar, but not identical, to scorpion alpha-toxins and sea anemone toxins. delta-Atracotoxins provide us with highly specific tools to study Na+ channel structure and function 4. omega- and Janus-faced ACTX, from funnel-web spider venom, are novel neurotoxins that show selective toxicity to insects. In particular omega-ACTX define a new insecticide target due to a specific action to block insect voltage-gated Ca2+ channels. Both these ACTX show promise for the development of baculoviral recombinant biopesticides expressing these toxins for the control of insecticide-resistant agricultural pests. In addition, they should provide valuable tools for the pharmacological and structural characterization of insecticide targets.

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Severe Lung Oedema and Fatal Consumption Coagulopathy after Funnel‐Web Bite

Cited by 28 publications

References 7 publications

Funnel‐web spider bite: a systematic review of recorded clinical cases

Funnel‐web spider bite: a systematic review of recorded clinical cases

SOME STUDIES OF THE OEDEMATOGENIC ACTION OF THE VENOM OF FUNNEL‐WEB SPIDERS (ATRAX SPECIES)

Spiders of medical importance in the Asia–Pacific: Atracotoxin, latrotoxin and related spider neurotoxins

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