Document Detail


A randomized blinded clinical trial of two antivenoms, prepared by caprylic acid or ammonium sulphate fractionation of IgG, in Bothrops and Porthidium snake bites in Colombia: correlation between safety and biochemical characteristics of antivenoms.
MedLine Citation:
PMID:  10340829     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A randomized blinded clinical trial was performed in 53 patients bitten by Bothrops sp. and Porthidium sp. in Antioquia and Chocó, Colombia, in order to compare the efficacy and safety of two antivenoms made of whole IgG obtained by either ammonium sulphate (monovalent anti-B. atrox) or caprylic acid (polyvalent) fractionation. Additionally, antivenoms were compared by electrophoretic and chromatographic analyses and anticomplementary activity in vitro. With a protocol of 2, 4 and 6 antivenom vials for the treatment of mild, moderate and severe envenomings, respectively, both antivenoms were equally efficient to neutralize the most relevant signs of envenoming and to clear serum venom levels in patients from the first hour and later on. Three patients with severe envenoming and initially treated with less than six vials on admission had persistent or recurrent venom antigenemia within 12-48 h. Monovalent antivenom fractionated by ammonium sulphate precipitation had higher amounts of protein aggregates and nonimmunoglobulin proteins than polyvalent antivenom fractionated by caprylic acid precipitation. Both antivenoms presented anticomplementary activity in vitro, being higher in the monovalent product. In agreement, monovalent antivenom induced a significantly higher incidence of early antivenom reactions (52%) than polyvalent antivenom (25%).
Authors:
R Otero; J M Gutiérrez; G Rojas; V Núñez; A Díaz; E Miranda; A F Uribe; J F Silva; J G Ospina; Y Medina; M F Toro; M E García; G León; M García; S Lizano; J De La Torre; J Márquez; Y Mena; N González; L C Arenas; A Puzón; N Blanco; A Sierra; M E Espinal; R Lozano
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Toxicon : official journal of the International Society on Toxinology     Volume:  37     ISSN:  0041-0101     ISO Abbreviation:  Toxicon     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1307333     Medline TA:  Toxicon     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  895-908     Citation Subset:  IM    
Affiliation:
Centro de Investigaciones Médicas, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Ammonium Sulfate / chemistry
Animals
Antivenins / adverse effects,  isolation & purification,  therapeutic use*
Bothrops*
Chemical Fractionation / methods
Child
Child, Preschool
Colombia
Crotalid Venoms / immunology*
Double-Blind Method
Horses
Humans
Immunoglobulin G / adverse effects,  isolation & purification,  therapeutic use*
Infant
Middle Aged
Octanoic Acids / chemistry
Safety
Snake Bites / therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antivenins; 0/Crotalid Venoms; 0/Immunoglobulin G; 0/Octanoic Acids; 124-07-2/caprylic acid; 7783-20-2/Ammonium Sulfate

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


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