Neurological Involvement and Hepatocellular Injury Caused by a Snake With Hematotoxin Envenomation

Sontichai, Watchareewan; Reungrongrat, Sanit; Narongchai, Paitoon; Natesirinilkul, Rungrote

doi:10.1016/j.wem.2015.02.006

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…It can be an important differentiating clinical feature between cobra and krait bite, rarely Russell viper bite may present with ptosis and cellulitis. (11,12) Treatment for snakebite patient is local care of the bitten site and anti-snake venom (ASV). In a study on Snake envenomation in a north Indian hospital Sharma N found that the mean dose of antivenom used for neuroparalytic snakebite was 51.2 vials (Range=5-190 vials) and 32 vials (Range=1-130 vials) for viper bites.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study of Neuroparalytic Snake Envenomation in a Tertiary Care Hospital of Chhattisgarh

Nigam¹,

Kosam²,

Debbarma³

et al. 2015

jemds

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AIMS:To study the clinical profile and outcome of neuroparalytic snake envenomation in a tertiary care hospital of Chhattisgarh. METHODS: This study is a retrospective, study including 165 patients of both sexes, who presented with history of snake bite or suspicion of snake bite. It was carried out at the Intensive care unit (ICU) of a Medical College hospital of Chhattisgarh during the period of January 2011 to December 2014. RESULTS: During period of 4 years, 165 cases of neuroparalytic snake envenomation were admitted in the ICU ward, out of which, 65 cases (39.40%) were of cobra and 100(60.60%) cases were of krait bite. 58(35.15%) cases required ventilatory support. Bites were more common in males. Male: female ratio was 5:3. Maximum cases occurred during the monsoon season and involved the lower limbs. Ptosis was the chief neurotoxic feature. Cellulitis as a complication was observed in most of the cases of cobra bite. Polyvalent Anti Snake Venom (ASV) was used, in a mean dose of 22 vials, as specific treatment. Deaths were reported in patients who reported late to the hospital with a mortality rate of 3.03%. No long term morbidity was observed. CONCLUSIONS: Snakebites are common in the rural population of developing countries like ours. There is a need to aware the public and medical staff about the complication of snakebite and benefit of early reporting to hospital.

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Section: Discussionmentioning

confidence: 99%

Retrospective Study of Neuroparalytic Snake Envenomation in a Tertiary Care Hospital of Chhattisgarh

Nigam¹,

Kosam²,

Debbarma³

et al. 2015

jemds

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Ocular sequelae of snakebite envenoming: a review of the indirect effects of snakebite envenoming on the eye

Jalink,

van Thiel,

Wouters

et al. 2023

Toxin Reviews

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Snakebite envenoming is a major public health issue in developing, often agricultural-based, tropical countries, which causes substantial mortality and morbidity. Most studies have been conducted on well-known toxic effects such as neurotoxicity, cytotoxicity, and hemotoxicity, however, there is scarce information on their indirect effects on the eye. In this review, we provide an overview of ocular pathologies caused by snakebite envenoming. In total, 65 cases, described in 42 case reports and series, were identified in the PubMed and Embase databases. Most reported ocular toxicities/disorders after snakebite envenoming were ophthalmoplegia (12 cases), intra-and peri-ocular hemorrhages (9 cases), and acute glaucoma (13 cases). We also discuss the possible mechanisms for these ocular pathologies. Interestingly, optic neuropathy might be an adverse effect of antivenom instead of directly being caused by envenoming. We prompt recognition of this largely overlooked topic within the field of snakebite, and further stress the need to combat this neglected tropical disease.

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Isolation and Pharmacological Characterisation of Pre-Synaptic Neurotoxins from Thai and Javanese Russell’s Viper (Daboia siamensis) Venoms

Lay,

Hodgson

2024

Toxins

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The widespread geographical distribution of Russell’s vipers (Daboia spp.) is associated with marked variations in the clinical outcomes of envenoming by species from different countries. This is likely to be due to differences in the quantity and potency of key toxins and, potentially, the presence or absence of some toxins in venoms across the geographical spectrum. In this study, we aimed to isolate and pharmacologically characterise the major neurotoxic components of D. siamensis venoms from Thailand and Java (Indonesia) and explore the efficacy of antivenom and a PLA2 inhibitor, Varespladib, against the neuromuscular activity. These data will provide insights into the link between venom components and likely clinical outcomes, as well as potential treatment strategies. Venoms were fractionated using RP-HPLC and the in vitro activity of isolated toxins assessed using the chick biventer cervicis nerve-muscle preparation. Two major PLA2 fractions (i.e., fractions 8 and 10) were isolated from each venom. Fraction 8 from both venoms produced pre-synaptic neurotoxicity and myotoxicity, whereas fraction 10 from both venoms was weakly neurotoxic. The removal of the two fractions from each venom abolished the in vitro neurotoxicity, and partially abolished myotoxicity, of the whole venom. A combination of the two fractions from each venom produced neurotoxic activity that was equivalent to the respective whole venom (10 µg/mL), but the myotoxic effects were not additive. The in vitro neurotoxicity of fraction 8 (100 nM) from each venom was prevented by the pre-administration of Thai Russell’s viper monovalent antivenom (2× recommended concentration) or preincubation with Varespladib (100 nM). Additionally, the neurotoxicity produced by a combination of the two fractions was partially reversed by the addition of Varespladib (100–300 nM) 60 min after the fractions. The present study demonstrates that the in vitro skeletal muscle effects of Thai and Javanese D. siamensis venoms are primarily due to key PLA2 toxins in each venom.

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Neurological Involvement and Hepatocellular Injury Caused by a Snake With Hematotoxin Envenomation

Cited by 3 publications

References 13 publications

Retrospective Study of Neuroparalytic Snake Envenomation in a Tertiary Care Hospital of Chhattisgarh

Retrospective Study of Neuroparalytic Snake Envenomation in a Tertiary Care Hospital of Chhattisgarh

Ocular sequelae of snakebite envenoming: a review of the indirect effects of snakebite envenoming on the eye

Isolation and Pharmacological Characterisation of Pre-Synaptic Neurotoxins from Thai and Javanese Russell’s Viper (Daboia siamensis) Venoms

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