An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia.

Autor:	Turetta M; Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy., Del Ben F; Department of Medical Area, University of Udine, Italy., Londero D; Immunohematology Laboratory, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy., Steffan A; Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy., Pillinini P; Department of Emergency Medicine, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy.
Jazyk:	angličtina
Zdroj:	Toxicology reports [Toxicol Rep] 2022 Mar 29; Vol. 9, pp. 636-639. Date of Electronic Publication: 2022 Mar 29 (Print Publication: 2022).
DOI:	10.1016/j.toxrep.2022.03.033
Abstrakt:	In this case report the hospital management of an acute, severe thrombocytopenia in a 57-year-old man in the north-east of Italy is reported. Thrombocytopenia developed immediately after the viper bite, despite the absence of clinical signs of envenomation. No hemorrhage, ecchymoses or other signs of coagulopathy developed during the hospitalization; two doses of antivenin FAB-Fragments had no effect on thrombocytopenia, which instead responded promptly to intravenous immunoglobulins (IVIg) and glucocorticoids. Direct and indirect anti-platelet antibodies against anti-GP IIb/IIIa and Ia/IIa were detected during the treatment and turned negative after 20 weeks. The rationale of such off-label treatment is the interpretation of the thrombocytopenia as a venom-induced immune thrombocytopenia which led to splenic sequestration of platelets. To our knowledge, there is no literature about venom-induced immune thrombocytopenia against GP IIb/IIIa and Ia/IIa protein in European countries and subsequent response to IVIg and corticosteroids. (© 2022 The Authors. Published by Elsevier B.V.)
Databáze:	MEDLINE
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