Introduction: Bothrops atrox snakebites are a major public health problem in the Amazon region and also cause hemostatic disorders. In this study, we assessed the recovery from hemostatic disorders in Bothrops snakebite patients after being given antivenom therapy. Methods: This is a prospective study of Bothrops snakebite patients (n = 100) treated at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazilian Amazon, between January 2016 and December 2017. Blood samples were taken for the measurement of venom concentrations, platelets, clotting time and factors of patients on admission, 12, 24 and 48 h after antivenom therapy, and taken again on discharge. The presence of systemic bleeding was recorded during the follow-up. Results: On admission, systemic bleeding was observed in 14% of the patients. Thrombocytopenia was noted in 10% of the patients. A total of 54% of the patients presented unclottable blood with low levels of fibrinogen and alpha 2-antiplasmin, and high levels of fibrin/fibrinogen degradation product (FDP) and D-dimers. Unclottable blood and systemic bleeding were overcome in most patients 12 h after the antivenom therapy. Three patients developed systemic bleeding 48 h after antivenom therapy. Levels of fibrinogen and alpha 2-antiplasmin, FDP and D-dimer returned to normal around 48 h after the treatment or on discharge. The frequency of thrombocytopenia with high mean platelet volume increased in the first 24 h after antivenom therapy, and decreased on discharge. Bothrops venom levels in patients decreased 12 h after antivenom therapy and were not correlated with coagulation and fibrinolytic parameters. There were no deaths. Conclusion: Laboratorial parameters of coagulopathy returned to normal values within 48 h after the antivenom therapy until discharge. A few patients still presented bleeding signs within 48 h after beginning antivenom therapy. However, the Brazilian antivenom was able to overcome the hemostatic disorders in these cases of envenomation.
Introduction: Bothrops atrox snakebites are a major public health problem in the Amazon region and also cause hemostatic disorders. In this study, we assessed the recovery from hemostatic disorders in Bothrops snakebite patients after being given antivenom therapy. Methods: This is a prospective study of Bothrops snakebite patients (n = 100) treated at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazilian Amazon, between January 2016 and December 2017. Blood samples were taken for the measurement of venom concentrations, platelets, clotting time and factors of patients on admission, 12, 24 and 48 h after antivenom therapy, and taken again on discharge. The presence of systemic bleeding was recorded during the follow-up. Results: On admission, systemic bleeding was observed in 14% of the patients. Thrombocytopenia was noted in 10% of the patients. A total of 54% of the patients presented unclottable blood with low levels of fibrinogen and alpha 2-antiplasmin, and high levels of fibrin/fibrinogen degradation product (FDP) and D-dimers. Unclottable blood and systemic bleeding were overcome in most patients 12 h after the antivenom therapy. Three patients developed systemic bleeding 48 h after antivenom therapy. Levels of fibrinogen and alpha 2-antiplasmin, FDP and D-dimer returned to normal around 48 h after the treatment or on discharge. The frequency of thrombocytopenia with high mean platelet volume increased in the first 24 h after antivenom therapy, and decreased on discharge. Bothrops venom levels in patients decreased 12 h after antivenom therapy and were not correlated with coagulation and fibrinolytic parameters. There were no deaths. Conclusion: Laboratorial parameters of coagulopathy returned to normal values within 48 h after the antivenom therapy until discharge. A few patients still presented bleeding signs within 48 h after beginning antivenom therapy. However, the Brazilian antivenom was able to overcome the hemostatic disorders in these cases of envenomation.
Authors: Gisele Dos Santos Rocha; Altair Seabra Farias; João Arthur Alcântara; Vinícius Azevedo Machado; Felipe Murta; Fernando Val; Joseir Saturnino Cristino; Alícia Cacau Santos; Mena Bianca Ferreira; Leonardo Marques; Yasmim Vieira Rocha; André Sachett; Mailma Costa Almeida; Aline Alencar; Lisele Brasileiro; Érica da Silva Carvalho; Pedro Ferreira Bisneto; Marcus Lacerda; Anna Tupetz; Catherine A Staton; João R N Vissoci; Elizabeth Teixeira; Charles J Gerardo; Fan Hui Wen; Jacqueline Sachett; Wuelton Monteiro Journal: Toxins (Basel) Date: 2022-05-28 Impact factor: 5.075
Authors: Wuelton Marcelo Monteiro; Jorge Carlos Contreras-Bernal; Pedro Ferreira Bisneto; Jacqueline Sachett; Iran Mendonça da Silva; Marcus Lacerda; Allyson Guimarães da Costa; Fernando Val; Lisele Brasileiro; Marco Aurélio Sartim; Sâmella Silva-de-Oliveira; Paulo Sérgio Bernarde; Igor L Kaefer; Felipe Gobbi Grazziotin; Fan Hui Wen; Ana Maria Moura-da-Silva Journal: Toxicon X Date: 2020-04-23
Authors: Lachlan A Bourke; Christina N Zdenek; Edgar Neri-Castro; Melisa Bénard-Valle; Alejandro Alagón; José María Gutiérrez; Eladio F Sanchez; Matt Aldridge; Bryan G Fry Journal: Toxins (Basel) Date: 2021-01-22 Impact factor: 4.546
Authors: Paulo Sérgio Bernarde; Manuela Berto Pucca; Ageane Mota-da-Silva; Wirven Lima da Fonseca; Marllus Rafael Negreiros de Almeida; Isadora Sousa de Oliveira; Felipe Augusto Cerni; Felipe Gobbi Grazziotin; Marco A Sartim; Jacqueline Sachett; Fan Hui Wen; Ana Maria Moura-da-Silva; Wuelton M Monteiro Journal: Front Immunol Date: 2021-12-15 Impact factor: 7.561
Authors: Sâmella S Oliveira; Eliane C Alves; Alessandra S Santos; Elizandra F Nascimento; João Pedro T Pereira; Iran M Silva; Jacqueline A G Sachett; Lybia Kássia S Sarraff; Luciana Aparecida Freitas-de-Sousa; Mônica Colombini; Hedylamar O Marques; Marcus V G Lacerda; Marco Aurélio Sartim; Ana Maria Moura-da-Silva; Luiz Carlos L Ferreira; Ida S Sano-Martins; Wuelton M Monteiro Journal: Toxins (Basel) Date: 2020-08-29 Impact factor: 4.546