HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ho, M. Articles by Vejcho, S. Search for Related Content PubMed PubMed Citation Articles by Ho, M. Articles by Vejcho, S. Pubmed/NCBI databases Substance via MeSH

Clinical Significance of Venom Antigen Levels in Patients Envenomed by the Malayan Pit Viper (Calloselasma Rhodostoma)

May Ho^*,,, David A. Warrell^*,,, Sornchai Looareesuwan^*, Rodney E. Phillips^*,,, Pornthep Chanthavanich^*, Juntra Karbwang^*, Wichai Supanaranond^*, Chaisin Viravan^*, Ronald A. Hutton AND Suthat Vejcho

^* Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Nuffield Department of Clinical Medicine, University of Oxford and Liverpool School of Tropical Medicine, England
The Katherine Dormandy Haemophilia Centre and Haemostasis Unit, The Royal Free Hospital, London, England
Trang Provincial Hospital, Trang, Thailand

Serial venom antigen levels were measured by enzyme-linked immunosorbent assay (ELISA) in 46 patients with systemic envenoming by the Malayan pit viper (Calloselasma rhodostoma), a major cause of snake bite in Southeast Asia. The principal effects of the venom are defibrination, hemorrhage and local tissue necrosis. Admission venom levels, which varied between 0 and 595 ng/ml, correlated with the incidence of spontaneous systemic bleeding, blood incoagulability and concentrations of plasma fibrinogen and serum fibrin degradation products. The presence or absence of nonclotting blood also correlated with the time elapsed between the bite and hospital admission. The development of nonclotting blood may be delayed by up to 72 hr after the bite even though circulating venom and raised FDP may be detected at presentation. This is probably explained by a temporary equilibrium between synthesis and consumption of fibrinogen. Venom antigenemia recurred in 12 patients (26%) suggesting continuous absorption of venom from the wound or saturation of extravascular binding sites. Admission venom levels also correlated with the extent of local swelling and the occurrence of tissue necrosis at the site of the bite. Venom was detected in 87% of wound aspirates and 88% of urine specimens taken on admission. Tourniquets, of the type used in rural Thailand, did not delay the absorption of venom into the circulation.

Accepted for publication November 14, 1985.

This article has been cited by other articles:

				A. A. Watson, J. A. Eble, and C. A. O'Callaghan Crystal structure of rhodocytin, a ligand for the platelet-activating receptor CLEC-2 Protein Sci., September 1, 2008; 17(9): 1611 - 1616. [Abstract] [Full Text] [PDF]

				D. A. Warrell, B. S. Gold, R. C. Dart, and R. A. Barish Bites of Venomous Snakes N. Engl. J. Med., November 28, 2002; 347(22): 1804 - 1805. [Full Text] [PDF]