Chippaux JP, Goyffon M , 2008. Epidemiology of scorpionism: a global appraisal. Acta Trop 107: 71–79.
Fatma El-Zahraa AAE-A, Shehaby DME, Elghazally SA, Hetta HF, 2019. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep 6: 329–335.
Badry A, Younes M, Sarhan MMH, Saleh M , 2017. On the scorpion fauna of Egypt, with an identification key (Arachnida: Scorpiones). Zool Middle East 64: 75–87.
Bahloul M, Bouaziz M, Dammak H, Hamida CB, Ksibi H, Rekik N, Chelly H, Teboul LJ, Kallel H , 2002. Value of the plasma protein and hemoglobin concentration in the diagnosis of pulmonary edema in scorpion sting patients. Intensive Care Med 28: 1600–1605.
Bahloul M et al.2004. Evidence of myocardial ischemia in severe scorpion envenomation: myocardial perfusion scintigraphy study. Intensive Care Med 30: 461–467.
Bahloul M et al.2010. Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg 83: 1084–1092.
Bouaziz M, Bahloul M, Hergafi L, Kallel H, Chaari L, Hamida CB, Chaari A, Chelly H, Rekik N , 2006. Factors associated with pulmonary edema in severe scorpion sting patients–a multivariate analysis of 428 cases. Clin Toxicol (Phila) 44: 293–300.
Bouaziz M et al.2008. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in south Tunisia: multivariate analysis of 951 cases. Toxicon 52: 918–926.
Devarbhavi PK, Vasudeva Murthy CR , 2013. Scorpion sting envenomation—an overview. J Clin Biomed Sci 3: 159–166.
Petricevich VL, 2010. Scorpion venom and the inflammatory response. Mediators Inflamm 2010: 903295. Epub 2010 Mar 14.
Bahloul M et al.2005. Neurological complications secondary to severe scorpion envenomation. Med Sci Monit 11: CR196–CR202.
Fong Y, Marano MA, Moldawer LL, Wei H, Calvano SE, Kenney JS, Allison AC, Cerami A, Shires GT, Lowry SF , 1990. The acute splanchnic and peripheral tissue metabolic response to endotoxin in humans. J Clin Invest 85: 1896.
Delarue J, Magnan C, 2007. Free fatty acids and insulin resistance. Curr Opin Clin Nutr Metab Care 10: 142–148.
Rockenfeller P et al., 2010. Fatty acids trigger mitochondrion-dependent necrosis. Cell Cycle 9: 2908–2914.
Khattabi A et al.2011. Classification of clinical consequences of scorpion stings: consensus development. Trans R Soc Trop Med Hyg 105: 364–369.
Isbister GK, Bawaskar HS , 2014. Scorpion envenomation. N Engl J Med 371: 457–463.
Baseer KA, Naser MAA, 2019. Predictors for mortality in children with scorpion envenomation admitted to pediatric intensive care unit, Qena Governorate, Egypt. Am J Trop Med Hyg 101: 941–994.
Medeiros de Araújo KA, Tavares AV, de Vasconcelos Marques MR, Vieira AA, de Souza Leite R , 2017. Epidemiological study of scorpion stings in the Rio Grande do Norte State, northeastern Brazil. Rev Inst Med Trop São Paulo 59: e58.
Prasad R, Mishra OP, Pandey N, Singh TB , 2011. Scorpion sting envenomation in children: factors affecting the outcome. Indian J Pediatr 78: 544–548.
Abroug F, Ayari M, Nouira S, Gamra H, Boujdaria R, Elatrous S, Farhat MB, Bouchoucha S , 1995. Assessment of left ventricular function in severe scorpion envenomation: combined hemodynamic and echo-Doppler study. Intensive Care Med 3: 629–635.
Gueron M, Illia R, Margulia G , 2000. Arthropod poisons and the cardiovascular system. Am J Emerg Med 18: 708–714.
Çağlar A, Köse H, Babayiğit A, Öner T, Duman M , 2015. Predictive factors for determining the clinical severity of pediatric scorpion envenomation cases in southeastern Turkey. Wilderness Environ Med 26: 451–458.
Bahloul M et al.2005. Gastrointestinal manifestations in severe scorpion envenomation. Gastroenterol Clin Biol 29: 1001–1005.
Cupo P , 2015. Clinical update on scorpion envenoming. Rev Soc Bras Med Trop 48: 642–649.
Radha Krishna Murthy K , 2013. Treatment of scorpion envenoming syndrome–need for scientific magnanimity. J Indian Med Assoc 111: 254–259.
Radha Krishna Murthy K, Haghnazari L , 1999. The blood levels of glucagon, cortisol, and insulin following the injection of venom by the scorpion (Mesobuthus tamulus concanesis, Pocock) in dogs. J Venom Anim Toxins 5: 47–55.
Harris D et al.2013. Glucocorticoid-induced hyperglycemia is prevalent and unpredictable for patients undergoing cancer therapy: an observational cohort study. Curr Oncol 20: e532–e538.
Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Hamida CB, Kallel H, Bouaziz M , 2013. Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol 162: 86–91.
Szabo T, Postrach E, Mähler A, Kung T, Turhan G, von Haehling S, Anker SD, Boschmann M, Doehner W , 2013. Increased catabolic activity in adipose tissue of patients with chronic heart failure. Eur J Heart Fail 15: 1131–1137.
Hirabara SM, Curi R, Maechler P , 2010. Saturated fatty acid-induced insulin resistance is associated with mitochondrial dysfunction in skeletal muscle cells. J Cell Physiol 222: 187–194.
Karwi QG, Uddin GM, Ho KL, Lopaschuk GD , 2018. Loss of metabolic flexibility in the failing heart. Front Cardiovasc Med 5: 68.
Jalali A, Pipelzadeh MH, Sayedian R, Rowan EG , 2010. A review of epidemiological, clinical and in vitro physiological studies of envenomation by the scorpion Hemiscorpius lepturus (Hemiscorpiidae) in Iran. Toxicon 55: 173–179.
Laribi S, Mebazaa A , 2014. Cardiohepatic syndrome: liver injury in decompensated heart failure. Curr Heart Fail Rep 11: 236–240.
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Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.
Authors’ addresses: Khaled Abdalla Abd-Elbaseer, Eman Ahmed Abd-Elmawgood, and H. M. Qubaisy, Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt, E-mails: khaledabdalla20@yahoo.com, emanpediatrics@yahoo.com, and hebaqubasy@gmail.com. Abdel-Rahman Abdel-Hamed El-Saied, Department of Clinical Pathology, Qena Faculty of Medicine, South Valley University, Egypt, E-mail: aelsaied@hotmail.com. Mohamed A. A. Abdel Naser, Department of Anaesthesia and ICU, Faculty of Medicine, Assiut University, Egypt, E-mail: monbasser@yahoo.com. Yaser F. Abd-Elraheem, Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt, E-mail: yaser.rezk@med.aun.edu.eg.
Chippaux JP, Goyffon M , 2008. Epidemiology of scorpionism: a global appraisal. Acta Trop 107: 71–79.
Fatma El-Zahraa AAE-A, Shehaby DME, Elghazally SA, Hetta HF, 2019. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep 6: 329–335.
Badry A, Younes M, Sarhan MMH, Saleh M , 2017. On the scorpion fauna of Egypt, with an identification key (Arachnida: Scorpiones). Zool Middle East 64: 75–87.
Bahloul M, Bouaziz M, Dammak H, Hamida CB, Ksibi H, Rekik N, Chelly H, Teboul LJ, Kallel H , 2002. Value of the plasma protein and hemoglobin concentration in the diagnosis of pulmonary edema in scorpion sting patients. Intensive Care Med 28: 1600–1605.
Bahloul M et al.2004. Evidence of myocardial ischemia in severe scorpion envenomation: myocardial perfusion scintigraphy study. Intensive Care Med 30: 461–467.
Bahloul M et al.2010. Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg 83: 1084–1092.
Bouaziz M, Bahloul M, Hergafi L, Kallel H, Chaari L, Hamida CB, Chaari A, Chelly H, Rekik N , 2006. Factors associated with pulmonary edema in severe scorpion sting patients–a multivariate analysis of 428 cases. Clin Toxicol (Phila) 44: 293–300.
Bouaziz M et al.2008. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in south Tunisia: multivariate analysis of 951 cases. Toxicon 52: 918–926.
Devarbhavi PK, Vasudeva Murthy CR , 2013. Scorpion sting envenomation—an overview. J Clin Biomed Sci 3: 159–166.
Petricevich VL, 2010. Scorpion venom and the inflammatory response. Mediators Inflamm 2010: 903295. Epub 2010 Mar 14.
Bahloul M et al.2005. Neurological complications secondary to severe scorpion envenomation. Med Sci Monit 11: CR196–CR202.
Fong Y, Marano MA, Moldawer LL, Wei H, Calvano SE, Kenney JS, Allison AC, Cerami A, Shires GT, Lowry SF , 1990. The acute splanchnic and peripheral tissue metabolic response to endotoxin in humans. J Clin Invest 85: 1896.
Delarue J, Magnan C, 2007. Free fatty acids and insulin resistance. Curr Opin Clin Nutr Metab Care 10: 142–148.
Rockenfeller P et al., 2010. Fatty acids trigger mitochondrion-dependent necrosis. Cell Cycle 9: 2908–2914.
Khattabi A et al.2011. Classification of clinical consequences of scorpion stings: consensus development. Trans R Soc Trop Med Hyg 105: 364–369.
Isbister GK, Bawaskar HS , 2014. Scorpion envenomation. N Engl J Med 371: 457–463.
Baseer KA, Naser MAA, 2019. Predictors for mortality in children with scorpion envenomation admitted to pediatric intensive care unit, Qena Governorate, Egypt. Am J Trop Med Hyg 101: 941–994.
Medeiros de Araújo KA, Tavares AV, de Vasconcelos Marques MR, Vieira AA, de Souza Leite R , 2017. Epidemiological study of scorpion stings in the Rio Grande do Norte State, northeastern Brazil. Rev Inst Med Trop São Paulo 59: e58.
Prasad R, Mishra OP, Pandey N, Singh TB , 2011. Scorpion sting envenomation in children: factors affecting the outcome. Indian J Pediatr 78: 544–548.
Abroug F, Ayari M, Nouira S, Gamra H, Boujdaria R, Elatrous S, Farhat MB, Bouchoucha S , 1995. Assessment of left ventricular function in severe scorpion envenomation: combined hemodynamic and echo-Doppler study. Intensive Care Med 3: 629–635.
Gueron M, Illia R, Margulia G , 2000. Arthropod poisons and the cardiovascular system. Am J Emerg Med 18: 708–714.
Çağlar A, Köse H, Babayiğit A, Öner T, Duman M , 2015. Predictive factors for determining the clinical severity of pediatric scorpion envenomation cases in southeastern Turkey. Wilderness Environ Med 26: 451–458.
Bahloul M et al.2005. Gastrointestinal manifestations in severe scorpion envenomation. Gastroenterol Clin Biol 29: 1001–1005.
Cupo P , 2015. Clinical update on scorpion envenoming. Rev Soc Bras Med Trop 48: 642–649.
Radha Krishna Murthy K , 2013. Treatment of scorpion envenoming syndrome–need for scientific magnanimity. J Indian Med Assoc 111: 254–259.
Radha Krishna Murthy K, Haghnazari L , 1999. The blood levels of glucagon, cortisol, and insulin following the injection of venom by the scorpion (Mesobuthus tamulus concanesis, Pocock) in dogs. J Venom Anim Toxins 5: 47–55.
Harris D et al.2013. Glucocorticoid-induced hyperglycemia is prevalent and unpredictable for patients undergoing cancer therapy: an observational cohort study. Curr Oncol 20: e532–e538.
Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Hamida CB, Kallel H, Bouaziz M , 2013. Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol 162: 86–91.
Szabo T, Postrach E, Mähler A, Kung T, Turhan G, von Haehling S, Anker SD, Boschmann M, Doehner W , 2013. Increased catabolic activity in adipose tissue of patients with chronic heart failure. Eur J Heart Fail 15: 1131–1137.
Hirabara SM, Curi R, Maechler P , 2010. Saturated fatty acid-induced insulin resistance is associated with mitochondrial dysfunction in skeletal muscle cells. J Cell Physiol 222: 187–194.
Karwi QG, Uddin GM, Ho KL, Lopaschuk GD , 2018. Loss of metabolic flexibility in the failing heart. Front Cardiovasc Med 5: 68.
Jalali A, Pipelzadeh MH, Sayedian R, Rowan EG , 2010. A review of epidemiological, clinical and in vitro physiological studies of envenomation by the scorpion Hemiscorpius lepturus (Hemiscorpiidae) in Iran. Toxicon 55: 173–179.
Laribi S, Mebazaa A , 2014. Cardiohepatic syndrome: liver injury in decompensated heart failure. Curr Heart Fail Rep 11: 236–240.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 2121 | 448 | 59 |
Full Text Views | 99 | 22 | 1 |
PDF Downloads | 84 | 20 | 1 |