Thrombotic microangiopathy following Bothrops jararaca snakebite: case report
| Autor: | Camila Carbone Prado, Stephen Hyslop, Carla F. Borrasca-Fernandes, Fábio Bucaretchi, Maira M. Branco Pimenta, Eduardo Mello De Capitani |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Thrombotic microangiopathy Bothrops jararaca ADAMTS13 Protein Snake Bites Context (language use) urologic and male genital diseases Toxicology 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Crotalid Venoms Animals Humans Medicine Bothrops 030212 general & internal medicine Envenomation neoplasms Severe complication biology Antivenins Thrombotic Microangiopathies business.industry 030208 emergency & critical care medicine General Medicine Middle Aged medicine.disease biology.organism_classification Dermatology digestive system diseases female genital diseases and pregnancy complications Female business Brazil |
| Zdroj: | Clinical Toxicology. 57:294-299 |
| ISSN: | 1556-9519 1556-3650 |
| DOI: | 10.1080/15563650.2018.1514621 |
| Popis: | Thrombotic microangiopathy (TMA) is an uncommon and severe complication of snakebites, and is similar, in general, to hemolytic-uremic syndrome (HUS). We describe a case of TMA following envenomation by Bothrops jararaca.A 56-y-old-woman with controlled hypertension was transferred from a primary hospital to our ER ∼7 h after being bitten by B. jararaca in the distal left leg. She developed edema extending from the bite site to the proximal thigh, associated with intense radiating local pain, local paresthesia and ecchymosis at the bite site. Laboratory features upon admission revealed coagulopathy (20 min whole blood clotting time - WBCT20 20 min), thrombocytopenia (76,000 platelets/mmTMA following snakebite has been reported mainly in India, Sri Lanka and Australia, with several patients needing renal replacement therapy. Although controversial, plasmapheresis has also been used in some cases. Our patient developed microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury, a triad of features compatible with TMA similar to HUS. Despite the severity, the outcome following conservative treatment was good, with complete recovery. |
| Databáze: | OpenAIRE |
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