Snake venom poisoning in Greece. Experiences with 147 cases

Frangides, Christos Y.; Koulouras, Vasilios; Kouni, Sophia N.; Tzortzatos, Gerasimos V.; Nikolaou, Athanasios; Pneumaticos, John; Pierrakeas, Christos; Niarchos, Constantinos; Kounis, Nicholas G.; Koutsojannis, Constantinos

doi:10.1016/j.ejim.2005.10.001

Cited by 40 publications

(34 citation statements)

References 10 publications

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“…The former, known as the adder, or common viper, is the most widely distributed viper in Europe, causing more bites than any of its congeners [1,2]. The latter, also called the nose-horned viper, the Western sand viper, the long-nosed viper or the rhinoceros viper, is the most venomous European snake, responsible for the majority of severe poisoning cases, especially in the south/eastern parts of Europe where it is the most common venomous snake and whose encounter with people is relatively frequent [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Venomics of Vipera berus berus to explain differences in pathology elicited by Vipera ammodytes ammodytes envenomation: Therapeutic implications

Latinović

Leonardi

Šribar

et al. 2016

Journal of Proteomics

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Section: Introductionmentioning

confidence: 99%

Venomics of Vipera berus berus to explain differences in pathology elicited by Vipera ammodytes ammodytes envenomation: Therapeutic implications

Latinović

Leonardi

Šribar

et al. 2016

Journal of Proteomics

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“…13 The most common symptoms of envenomation after bites by European vipers are extensive local swelling and necrosis, abdominal pain, vomiting and diarrhea, hypotension or shock from vasodilation, and leakage with generalized edema, hemolysis, and renal failure. 12 Arterial thrombotic complications at vessels near bite mark from viper have been well described, but arterial thromboses in distant places are rare and involve the cerebral, coronary, or intestinal vessels. 11 Pulmonary embolic episodes after viper bites are extremely rare.…”

Section: Discussionmentioning

confidence: 99%

“…14 In a nationwide study in Greece, none out of 147 patients who suffered a snake bite, developed pulmonary embolism. 12 It is possible that unknown thrombophilic factors in apparently healthy people trigger thrombosis in certain conditions, such as envenomation from snake bite.…”

Section: Discussionmentioning

confidence: 99%

“…In Europe, there are about 25 viper species, with endemic species in Greece being V. ammodytes, V. aspis, V. lebetina, and V. xanthina. 12 Viper venoms contain more than 20 different constituents, mainly proteins, including enzymes and polypeptide toxins. Procoagulant enzymes (Viperidae) stimulate blood clotting but result in uncoagulable blood.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Embolism After Snake Bite in a Child With Diamond-Blackfan Anemia

Makis

Kattamis²,

Grammeniatis³

et al. 2011

Journal of Pediatric Hematology/Oncology

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Diamond-Blackfan anemia (DBA) is a rare, congenital, pure red blood cell aplasia owing to gene defects affecting the function of ribosomal proteins, essential for erythroid maturation. Iron overload is a serious complication of chronic transfusions, which may lead to cardiac toxicity and endothelial damage. We report a case of pulmonary embolism, observed after viper bite in a transfusion-dependent child with DBA without known inherited thrombophilic factors. Embolic events are uncommon after viper bites, which they usually cause consumption coagulopathy, resulting in hypocoagulable state. DBA has not been earlier correlated with thrombotic episodes. In our patient, we suggest an iron overload-induced hypercoagulability state, which in the presence of a procoagulant substance lead to the development of a thromboembolic event.

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“…Frangides et al 22 have described that viperine bites are the most common in Greece. However, they have not described any myocardial infarctions.…”

Section: Discussionmentioning

confidence: 99%

+Ophitoxaemia and myocardial infarction—the issues during primary angioplasty: a review

Gupta¹,

Thomas²,

Francis³

et al. 2014

BMJ Case Reports

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SUMMARY'The Big four' are the most poisonous snakes in India, and especially in Kerala. These include the cobra, the viper, the krait and the sea snake. Most of the poisonous snakebites in India occur in Kerala. We believe there are only a few reports of myocardial infarction after snakebites and most of these are viper bites. We believe this is the second case of primary angioplasty for a snakebite. There are at least a few potential issues in performing a primary angioplasty in a snakebite case, namely (1) Is it a thrombus or a spasm? (2) Are the bleeding parameters deranged? Will the patient tolerate tirofiban and other glycoprotein (GB) 2b3a inhibitors? Will he develop dangerous bleeding due to the high dose of heparin needed? Further, would we save the patient from myocardial infarction only to lose him to renal failure, both due to the nephrotoxicity of the venom, the kidney being further damaged by the contrast media used for the angioplasty? We discuss all these issues as they crossed our mind, and hope it will help further treatment in others. We would like to review the available literature on these points and describe a recent case of ours. BACKGROUND

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Snake venom poisoning in Greece. Experiences with 147 cases

Cited by 40 publications

References 10 publications

Venomics of Vipera berus berus to explain differences in pathology elicited by Vipera ammodytes ammodytes envenomation: Therapeutic implications

Venomics of Vipera berus berus to explain differences in pathology elicited by Vipera ammodytes ammodytes envenomation: Therapeutic implications

Pulmonary Embolism After Snake Bite in a Child With Diamond-Blackfan Anemia

+Ophitoxaemia and myocardial infarction—the issues during primary angioplasty: a review

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