Document Detail


Blood coagulation abnormalities associated with envenoming by Trimeresurus albolabris in Hong Kong.
MedLine Citation:
PMID:  8266156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Snake bites in Hong Kong are most commonly due to Tr. albolabris (White-lipped pit viper, bamboo snake). We studied 21 cases of envenoming by Tr. albolabris prospectively in order to document the incidence and severity of associated coagulation abnormalities. Eighteen patients (86%) had increased blood concentrations of fibrin degradation products (FDP) ranging from 10-40 micrograms/l to greater than 200 micrograms/l (normal: less than 10 micrograms/l), the majority of whom also had detectable soluble fibrin monomers. Among these 21 patients, 10 had decreased blood concentrations of fibrinogen ranging from 0.3 kg/l to 1.9 g/l (normal: 2-4 gl/l). In 11 cases (52%), the euglobulin clot lysis time was shortened (less than 150 minutes) in association with elevated blood concentrations of FDP (n = 10) and decreased circulating fibrinogen levels (n = 8). Thrombocytopenia and/or prolongation of prothrombin time (PT), activated partial thromboplastin time (APTT) and/or thrombin time (TT) were present in 10 patients (28%). Increased blood concentrations of FDP and decreased circulating fibrinogen levels were present in most of these cases. Envenoming by Tr. albolabris is therefore frequently associated with a coagulopathy compatible with increased fibrin/fibrinogenolysis. Measurement of blood concentrations of FDP is the most sensitive test for detecting the coagulopathy. There is, however, little correlation between the patterns of clinical manifestations and coagulation abnormalities although more severe clinical features were usually associated with high circulating FDP levels. Only one patient developed systemic bleeding but no fatality was observed. The coagulation abnormalities are usually correctable by replacement therapy. Further studies are required to study the mechanisms of this coagulopathy and its relationship with venom antigenaemia.
Authors:
J C Chan; M M Kwok; C S Cockram; M N Prematilleke; B Tomlinson; J A Critchley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  34     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1994-01-24     Completed Date:  1994-01-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  SINGAPORE    
Other Details:
Languages:  eng     Pagination:  145-7     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Animals
Blood Coagulation Disorders / blood,  etiology*
Blood Coagulation Tests
Crotalid Venoms / adverse effects*
Female
Fibrin / analysis
Fibrin Fibrinogen Degradation Products / analysis
Fibrinogen / analysis
Hong Kong
Humans
Male
Middle Aged
Prospective Studies
Serum Globulins / analysis
Snake Bites / complications*
Thrombocytopenia / blood
Viperidae*
Chemical
Reg. No./Substance:
0/Crotalid Venoms; 0/Fibrin Fibrinogen Degradation Products; 0/Serum Globulins; 9001-31-4/Fibrin; 9001-32-5/Fibrinogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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