ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2021. Snakebite Envenoming. Available at: https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming. Accessed July 8, 2023.
-
2.
World Health Organization , 2016. Guidelines for the Management of Snakebites, 2nd Edition. Available at: https://www.who.int/publications-detail-redirect/9789290225300. Accessed July 8, 2023.
-
3.
Tangtrongchitr T , Thumtecho S , Janprasert J , Sanprasert K , Tongpoo A , Tanpudsa Y , Trakulsrichai S , Wananukul W , Sahaphume S , 2021. Malayan pit viper envenomation and treatment in Thailand. Ther Clin Risk Manag 17: 1257–1266.
-
4.
Wongtongkam N , Wilde H , Sitthi-Amorn C , Ratanabanangkoon K , 2005. A study of 225 Malayan pit viper bites in Thailand. Mil Med 170: 342–348.
-
5.
Tan NH , Ponnudurai G , 1996. The toxinology of Calloselasma rhodostoma (Malayan pit viper) venom. J Toxicol Toxin Rev 15: 1–17.
-
6.
Lertsakulbunlue S , Suebtuam R , Eamchotchawalit T , Chantkran W , Chaisakul J , 2023. Clinical profile and pharmacological management of snakebites in community care units: a retrospective study using two military hospital databases in South Thailand. Trop Med Infect Dis 8: 346.
-
7.
Rojnuckarin P , Suteparak S , Sibunruang S , 2012. Review article. Diagnosis and management of venomous snakebites in Southeast Asia. Asian Biomed 6: 795–805.
-
8.
Rojnuckarin P , Intragumtornchai T , Sattapiboon R , Muanpasitporn C , Pakmanee N , Khow O , Sawasdikul D , 1999. The effects of green pit viper (Trimeresurus albolabris and Trimeresurus macrops) venom on the fibrinolytic system in human. Toxicon 37: 743–755.
-
9.
Warrell DA et al., 1986. Randomized comparative trial of three monospecific antivenoms for bites by the Malayan pit viper (Calloselasma rhodostoma) in southern Thailand: clinical and laboratory correlations. Am J Trop Med Hyg 35: 1235–1247.
-
10.
Maduwage K , Isbister GK , 2014. Current treatment for venom-induced consumption coagulopathy resulting from snakebite. PLoS Negl Trop Dis 8: e3220.
-
11.
Khimmaktong W , Nuanyaem N , Lorthong N , Hodgson WC , Chaisakul J , 2022. Histopathological changes in the liver, heart and kidneys following malayan pit viper (Calloselasma rhodostoma) envenoming and the neutralising effects of hemato polyvalent snake antivenom. Toxins (Basel) 14: 601.
-
12.
Tang ELH , Tan NH , Fung SY , Tan CH , 2019. Comparative proteomes, immunoreactivities and neutralization of procoagulant activities of Calloselasma rhodostoma (Malayan pit viper) venoms from four regions in Southeast Asia. Toxicon 169: 91–102.
-
13.
Osipov A , Utkin Y , 2023. What are the neurotoxins in hemotoxic snake venoms? Int J Mol Sci 4: 2919.
-
14.
Tongpoo A , Sriapha C , Pradoo A , Udomsubpayakul U , Srisuma S , Wananukul W , Trakulsrichai S , 2018. Krait envenomation in Thailand. Ther Clin Risk Manag 14: 1711–1717.
-
15.
Pucca MB , Knudsen C , Oliveira IS , Rimbault C , Cerni FA , Wen FH , Sachett J , Sartim MA , Laustsen AH , Monteiro WM , 2020. Current knowledge on snake dry bites. Toxins (Basel) 12: 668.
-
16.
Kularatne SA , Budagoda BD , Gawarammana IB , Kularatne WK , 2009. Epidemiology, clinical profile and management issues of cobra (Naja naja) bites in Sri Lanka: first authenticated case series. Trans R Soc Trop Med Hyg 103: 924–930.
-
17.
Valenta J , Stach Z , Stříteský M , Michálek P , 2014. Common viper bites in the Czech Republic—epidemiological and clinical aspects during 15 year period (1999–2013). Prague Med Rep 115: 120–127.
-
18.
Roth B , Sharma K , Onisko N , Chen T , 2016. Prospective evaluation of pain, swelling, and disability from copperhead envenomation. Clin Toxicol (Phila) 54: 271–276.
-
19.
Schlappi C , Kulkarni V , Palabindela P , Bemrich-Stolz C , Howard T , Hilliard L , Lebensburger J , 2018. Outcomes in mild to moderate isolated thrombocytopenia. Pediatrics 142: e20173804.
-
20.
Mank V , Azhar W , Brown K , 2023. Leukocytosis. StatPearls. Treasure Island, FL: StatPearls Publishing. Available at: http://www.ncbi.nlm.nih.gov/books/NBK560882/. Accessed July 8, 2023.
-
21.
Kyriakides J , 2021. Exertional rhabdomyolysis: a case report of an exceptionally elevated serum creatine kinase (CK) level. Int J Sports Exerc Med 7: 203.
-
22.
Lameire NH , Levin A , Kellum JA , Cheung M , Jadoul M , Winkelmayer WC , Stevens PE , 2021. Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) consensus conference. Kidney Int 100: 516–526.
-
23.
Reid HA , Thean PC , Chan KE , Baharom AR , 1963. Clinical effects of bites by Malayan viper (Ancistrodon rhodostoma). Lancet 1: 617–621.
-
24.
Vongphoumy I , Chanthilat P , Vilayvong P , Blessmann J , 2016. Prospective, consecutive case series of 158 snakebite patients treated at Savannakhet provincial hospital, Lao People’s Democratic Republic with high incidence of anaphylactic shock to horse derived F(ab′)2 antivenom. Toxicon 117: 13–21.
-
25.
Looareesuwan S , Viravan C , Warrell DA , 1988. Factors contributing to fatal snake bite in the rural tropics: analysis of 46 cases in Thailand. Trans R Soc Trop Med Hyg 82: 930–934.
-
26.
Laohawiriyakamol S , Sangkhathat S , Chiengkriwate P , Patrapinyokul S , 2011. Surgery in management of snake envenomation in children. World J Pediatr 7: 361–364.
-
27.
Kraisawat K , Promwang N , 2020. Duration after Malayan pit viper bite to detect coagulopathy in Songklanagarind Hospital. J Health Sci Med Res 38: 93–101.
-
28.
Viravan C , Looareesuwan S , Kosakarn W , Wuthiekanun V , McCarthy CJ , Stimson AF , Bunnag D , Harinasuta T , Warrell DA , 1992. A national hospital-based survey of snakes responsible for bites in Thailand. Trans R Soc Trop Med Hyg 86: 100–106.
-
29.
Wedasingha S , Isbister G , Silva A , 2020. Bedside coagulation tests in diagnosing venom-induced consumption coagulopathy in snakebite. Toxins (Basel) 12: 583.
-
30.
Pongpit J , Limpawittayakul P , Juntiang J , Akkawat B , Rojnuckarin P , 2012. The role of prothrombin time (PT) in evaluating green pit viper (Cryptelytrops sp) bitten patients. Trans R Soc Trop Med Hyg 106: 415–418.
-
31.
Othong R , Eurcherdkul T , Chantawatsharakorn P , 2022. Green pit viper envenomations in Bangkok: a comparison of follow-up compliance and clinical outcomes in older and younger adults. Toxins (Basel) 14: 869.
-
32.
Thongtonyong N , Chinthammitr Y , 2020. Sensitivity and specificity of 20-minute whole blood clotting test, prothrombin time, activated partial thromboplastin time tests in diagnosis of defibrination following Malayan pit viper envenoming. Toxicon 185: 188–192.
-
33.
Guo PC , Zhao GF , Zhong HM , 2020. A case of rhabdomyolysis with compartment syndrome in the right upper extremity. World J Emerg Med 11: 185–187.
-
34.
Chaisakul J , Alsolaiss J , Charoenpitakchai M , Wiwatwarayos K , Sookprasert N , Harrison RA , Chaiyabutr N , Chanhome L , Tan CH , Casewell NR , 2019. Evaluation of the geographical utility of Eastern Russell’s viper (Daboia siamensis) antivenom from Thailand and an assessment of its protective effects against venom-induced nephrotoxicity. PLoS Negl Trop Dis 13: e0007338.
-
35.
Zuliani JP , Soares AM , Gutiérrez JM , 2020. Polymorphonuclear neutrophil leukocytes in snakebite envenoming. Toxicon 187: 188–197.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1029 | 1029 | 53 |
| Full Text Views | 49 | 49 | 1 |
| PDF Downloads | 63 | 63 | 1 |
Clinical Laboratory Investigations and Antivenom Administration after Malayan Pit Viper (Calloselasma rhodostoma) Envenoming: A Retrospective Study from Southernmost Thailand
Musleeha Chesor
Musleeha Chesor
Faculty of Medicine, Princess of Naradhiwas University, Narathiwat, Thailand;
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Janeyuth Chaisakul
Janeyuth Chaisakul
Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand;
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Panuwat Promsorn
Panuwat Promsorn
Galyani Vadhana Karun Hospital, Faculty of Medicine, Princess of Naradhiwas University, Narathiwat, Thailand;
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Wittawat Chantkran
Wittawat Chantkran
Department of Pathology, Phramongkutklao College of Medicine, Bangkok, Thailand
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ABSTRACT.
The Malayan pit viper (MPV: Calloselasma rhodostoma) is a medically important venomous snake causing numerous envenomations in Thailand. Administration of specific snake antivenom is the only effective treatment for MPV-envenomed patients. However, inappropriate administration or misuse of snake antivenom is problematic in some remote areas of tropical countries where the snakebite envenoming rate is notable. Currently, the indications for administration of MPV antivenom are focused mainly on hematological factors. These include 1) venous clotting time > 20 min, 2) unclotted 20-minute whole-blood clotting time, 3) international normalized ratio > 1.2, 4) platelet count < 50 × 103/μL, 5) systemic bleeding, and 6) impending compartment syndrome. We aimed to determine the association between laboratory data and antivenom administration in MPV-envenomed patients. A retrospective study of data from 2016 to 2021 in Narathiwat Province, the southernmost province in Thailand, was conducted. A total of 838 MPV-bitten patients were included in this study. Local effects and systemic effects were observed in 58.8% and 27.7% of patients, respectively. Coagulopathies, which range from abnormal blood clotting to systemic bleeding, represented the majority of systemic effects. Acute kidney injury developed in 2.5% of patients. In this study, 57.3% of patients were considered appropriate antivenom recipients. Interestingly, the present study revealed that local bleeding and mild to moderate thrombocytopenia became the independent factors for inappropriate use of MPV antivenom. Reeducation and supervision regarding the rational use of snake antivenom are needed to minimize the misuse of antivenom.
Author Notes
Data availability: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Financial support: This research was supported by a Dr. Prasert Prasarttong-Osoth Research grant, which is administered by the Medical Association of Thailand under His Majesty the King’s Patronage. Additional funding was provided by the
Authors’ addresses: Musleeha Chesor, Faculty of Medicine, Princess of Naradhiwas University, Narathiwat, Thailand, E-mail: musleeha.c@pnu.ac.th. Janeyuth Chaisakul, Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand, E-mail: jchaisakul@gmail.com. Panuwat Promsorn, Galyani Vadhana Karun Hospital, Faculty of Medicine, Princess of Naradhiwas University, Narathiwat, Thailand, E-mail: panuwat.p@pnu.ac.th. Wittawat Chantkran, Department of Pathology, Phramongkutklao College of Medicine, Bangkok, Thailand, E-mail: chantkran@yahoo.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2021. Snakebite Envenoming. Available at: https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming. Accessed July 8, 2023.
-
2.
World Health Organization , 2016. Guidelines for the Management of Snakebites, 2nd Edition. Available at: https://www.who.int/publications-detail-redirect/9789290225300. Accessed July 8, 2023.
-
3.
Tangtrongchitr T , Thumtecho S , Janprasert J , Sanprasert K , Tongpoo A , Tanpudsa Y , Trakulsrichai S , Wananukul W , Sahaphume S , 2021. Malayan pit viper envenomation and treatment in Thailand. Ther Clin Risk Manag 17: 1257–1266.
-
4.
Wongtongkam N , Wilde H , Sitthi-Amorn C , Ratanabanangkoon K , 2005. A study of 225 Malayan pit viper bites in Thailand. Mil Med 170: 342–348.
-
5.
Tan NH , Ponnudurai G , 1996. The toxinology of Calloselasma rhodostoma (Malayan pit viper) venom. J Toxicol Toxin Rev 15: 1–17.
-
6.
Lertsakulbunlue S , Suebtuam R , Eamchotchawalit T , Chantkran W , Chaisakul J , 2023. Clinical profile and pharmacological management of snakebites in community care units: a retrospective study using two military hospital databases in South Thailand. Trop Med Infect Dis 8: 346.
-
7.
Rojnuckarin P , Suteparak S , Sibunruang S , 2012. Review article. Diagnosis and management of venomous snakebites in Southeast Asia. Asian Biomed 6: 795–805.
-
8.
Rojnuckarin P , Intragumtornchai T , Sattapiboon R , Muanpasitporn C , Pakmanee N , Khow O , Sawasdikul D , 1999. The effects of green pit viper (Trimeresurus albolabris and Trimeresurus macrops) venom on the fibrinolytic system in human. Toxicon 37: 743–755.
-
9.
Warrell DA et al., 1986. Randomized comparative trial of three monospecific antivenoms for bites by the Malayan pit viper (Calloselasma rhodostoma) in southern Thailand: clinical and laboratory correlations. Am J Trop Med Hyg 35: 1235–1247.
-
10.
Maduwage K , Isbister GK , 2014. Current treatment for venom-induced consumption coagulopathy resulting from snakebite. PLoS Negl Trop Dis 8: e3220.
-
11.
Khimmaktong W , Nuanyaem N , Lorthong N , Hodgson WC , Chaisakul J , 2022. Histopathological changes in the liver, heart and kidneys following malayan pit viper (Calloselasma rhodostoma) envenoming and the neutralising effects of hemato polyvalent snake antivenom. Toxins (Basel) 14: 601.
-
12.
Tang ELH , Tan NH , Fung SY , Tan CH , 2019. Comparative proteomes, immunoreactivities and neutralization of procoagulant activities of Calloselasma rhodostoma (Malayan pit viper) venoms from four regions in Southeast Asia. Toxicon 169: 91–102.
-
13.
Osipov A , Utkin Y , 2023. What are the neurotoxins in hemotoxic snake venoms? Int J Mol Sci 4: 2919.
-
14.
Tongpoo A , Sriapha C , Pradoo A , Udomsubpayakul U , Srisuma S , Wananukul W , Trakulsrichai S , 2018. Krait envenomation in Thailand. Ther Clin Risk Manag 14: 1711–1717.
-
15.
Pucca MB , Knudsen C , Oliveira IS , Rimbault C , Cerni FA , Wen FH , Sachett J , Sartim MA , Laustsen AH , Monteiro WM , 2020. Current knowledge on snake dry bites. Toxins (Basel) 12: 668.
-
16.
Kularatne SA , Budagoda BD , Gawarammana IB , Kularatne WK , 2009. Epidemiology, clinical profile and management issues of cobra (Naja naja) bites in Sri Lanka: first authenticated case series. Trans R Soc Trop Med Hyg 103: 924–930.
-
17.
Valenta J , Stach Z , Stříteský M , Michálek P , 2014. Common viper bites in the Czech Republic—epidemiological and clinical aspects during 15 year period (1999–2013). Prague Med Rep 115: 120–127.
-
18.
Roth B , Sharma K , Onisko N , Chen T , 2016. Prospective evaluation of pain, swelling, and disability from copperhead envenomation. Clin Toxicol (Phila) 54: 271–276.
-
19.
Schlappi C , Kulkarni V , Palabindela P , Bemrich-Stolz C , Howard T , Hilliard L , Lebensburger J , 2018. Outcomes in mild to moderate isolated thrombocytopenia. Pediatrics 142: e20173804.
-
20.
Mank V , Azhar W , Brown K , 2023. Leukocytosis. StatPearls. Treasure Island, FL: StatPearls Publishing. Available at: http://www.ncbi.nlm.nih.gov/books/NBK560882/. Accessed July 8, 2023.
-
21.
Kyriakides J , 2021. Exertional rhabdomyolysis: a case report of an exceptionally elevated serum creatine kinase (CK) level. Int J Sports Exerc Med 7: 203.
-
22.
Lameire NH , Levin A , Kellum JA , Cheung M , Jadoul M , Winkelmayer WC , Stevens PE , 2021. Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) consensus conference. Kidney Int 100: 516–526.
-
23.
Reid HA , Thean PC , Chan KE , Baharom AR , 1963. Clinical effects of bites by Malayan viper (Ancistrodon rhodostoma). Lancet 1: 617–621.
-
24.
Vongphoumy I , Chanthilat P , Vilayvong P , Blessmann J , 2016. Prospective, consecutive case series of 158 snakebite patients treated at Savannakhet provincial hospital, Lao People’s Democratic Republic with high incidence of anaphylactic shock to horse derived F(ab′)2 antivenom. Toxicon 117: 13–21.
-
25.
Looareesuwan S , Viravan C , Warrell DA , 1988. Factors contributing to fatal snake bite in the rural tropics: analysis of 46 cases in Thailand. Trans R Soc Trop Med Hyg 82: 930–934.
-
26.
Laohawiriyakamol S , Sangkhathat S , Chiengkriwate P , Patrapinyokul S , 2011. Surgery in management of snake envenomation in children. World J Pediatr 7: 361–364.
-
27.
Kraisawat K , Promwang N , 2020. Duration after Malayan pit viper bite to detect coagulopathy in Songklanagarind Hospital. J Health Sci Med Res 38: 93–101.
-
28.
Viravan C , Looareesuwan S , Kosakarn W , Wuthiekanun V , McCarthy CJ , Stimson AF , Bunnag D , Harinasuta T , Warrell DA , 1992. A national hospital-based survey of snakes responsible for bites in Thailand. Trans R Soc Trop Med Hyg 86: 100–106.
-
29.
Wedasingha S , Isbister G , Silva A , 2020. Bedside coagulation tests in diagnosing venom-induced consumption coagulopathy in snakebite. Toxins (Basel) 12: 583.
-
30.
Pongpit J , Limpawittayakul P , Juntiang J , Akkawat B , Rojnuckarin P , 2012. The role of prothrombin time (PT) in evaluating green pit viper (Cryptelytrops sp) bitten patients. Trans R Soc Trop Med Hyg 106: 415–418.
-
31.
Othong R , Eurcherdkul T , Chantawatsharakorn P , 2022. Green pit viper envenomations in Bangkok: a comparison of follow-up compliance and clinical outcomes in older and younger adults. Toxins (Basel) 14: 869.
-
32.
Thongtonyong N , Chinthammitr Y , 2020. Sensitivity and specificity of 20-minute whole blood clotting test, prothrombin time, activated partial thromboplastin time tests in diagnosis of defibrination following Malayan pit viper envenoming. Toxicon 185: 188–192.
-
33.
Guo PC , Zhao GF , Zhong HM , 2020. A case of rhabdomyolysis with compartment syndrome in the right upper extremity. World J Emerg Med 11: 185–187.
-
34.
Chaisakul J , Alsolaiss J , Charoenpitakchai M , Wiwatwarayos K , Sookprasert N , Harrison RA , Chaiyabutr N , Chanhome L , Tan CH , Casewell NR , 2019. Evaluation of the geographical utility of Eastern Russell’s viper (Daboia siamensis) antivenom from Thailand and an assessment of its protective effects against venom-induced nephrotoxicity. PLoS Negl Trop Dis 13: e0007338.
-
35.
Zuliani JP , Soares AM , Gutiérrez JM , 2020. Polymorphonuclear neutrophil leukocytes in snakebite envenoming. Toxicon 187: 188–197.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1029 | 1029 | 53 |
| Full Text Views | 49 | 49 | 1 |
| PDF Downloads | 63 | 63 | 1 |