Evaluation of platelet number and function and fibrinogen level in patients bitten by snakes of the Bothrops genus

Abstract

Platelet function and plasma fibrinogen levels were evaluated in 14 patients, 10 males and 4 females, aged 13-59 years bitten by Bothrops genus snakes. There was a statistical difference (p < 0.05) among plasma fibrinogen levels evaluated 24 and 48 hours after envenomation. There was a tendency towards normalization after 48 hours of treatment. The low platelet number was clear in 24-48 hour evaluations with a tendency towards normalization after 48 hours of treatment (p < 0.05). When platelet function was stimulated by collagen and epinephrine, it appeared to be within normal values. On the other hand, when it was stimulated by adenosine diphosphate (ADP), platelet function was hypoaggregated by a single micromol concentration until 48 hours after treatment. At a 3 micromol concentration, there were alterations only before specific treatment (p < 0.05). Fibrinogen levels and fibrin degradation product (FDP) levels appeared to be altered in 83.33% of patients evaluated. The authors suggest that platelet hypoaggregation is related to decreased fibrinogen and increased FDP levels.

Envenenamento por serpente Bothrops no município de Afuá, Ilha de Marajó, estado do Pará, Brasil

“…O veneno botrópico pode também levar a alterações da função plaquetária bem como plaquetopenia. Essas alterações na coagulação sanguínea são as principais características dos envenenamentos por serpentes da família Viperidae 2,17,18,19 .…”

“…O processo infeccioso local é ocasionado por bactérias existentes na boca do animal ou na pele do acidentado, contaminando assim o ferimento. De acordo com a literatura, os ferimentos causados por picadas de serpentes são potencialmente contaminados e, dessa forma, predispostos à necrose e infecção bacteriana, que pode ser agravada pelo uso de torniquete 17,18 . Embora ainda seja rotineiro o uso de antibióticos como profilaxia, o mesmo só deverá ser indicado quando houver evidência de infecção 1,2,6 .…”

Treatment of Chronic Venous Ulcers With Heterologous Fibrin Sealant: A Phase I/II Clinical Trial

“…To ascertain laboratory safety, particularly the possible AEs of the thrombin-like enzyme extracted from the venom of Crotalus durissus terrificus, the blood coagulation system of the participants was evaluated. According to the medical literature, envenomation caused by these snakes triggers important changes in blood coagulation through the consumption of coagulation factors, mainly fibrinogen and platelets (38)(39)(40)(41). In the present study, there were no significant alterations in the levels of platelets, fibrinogen, or the erythrocyte sedimentation rate (ESR) compared to the evaluations made before, during, and at the end of treatment.…”