- Title
- Antivenom cross neutralisation in a suspected Asian pit viper envenoming causing severe coagulopathy
- Creator
- Isbister, G. K.; Maduwage, K.; Page, C. B.
- Relation
- NHMRC.631073 and MHMRC.1061041
- Relation
- Toxicon Vol. 90, p. 286-290
- Publisher Link
- http://dx.doi.org/10.1016/j.toxicon.2014.08.071
- Publisher
- Pergamon Press
- Resource Type
- journal article
- Date
- 2014
- Description
- There is evidence of cross-neutralisation between common toxin groups in snake venoms and therefore the potential for antivenoms to be effective against species they are not raised against. Here we present a 49 year old female bitten by an unknown pit-viper in Nepal. She developed a venom induced consumption coagulopathy with an unrecordable international normalised ratio and undetectable fibrinogen. On return to Australia 5 days post-bite she was treated successfully with one antivenom raised against Malayan pit viper and green pit viper venoms (Haemato-polvalent antivenom from Thailand) and then subsequently with another antivenom raised against American pit-viper venoms (Antivipmyn). Presumed pit viper venom was detected in patient sera with an enzyme immunoassay against Hypnale hypnale venom. There was increased absorbance before antivenom compared to non-envenomed control samples, which then decreased after the administration of each antivenom. The recurrence of venom detected by enzyme immunoassay between antivenom doses was accompanied by a recurrence of the coagulopathy. Cross reactivity between the unknown venom and both antivenoms was supported by the fact that no venom was detected in the pre-antivenom samples after they were incubated in-vitro with both antivenoms. This case and investigation of the venom and antivenoms suggest cross-neutralisation between pit vipers, including pit vipers from different continents.
- Subject
- antivenom; cross-neutralisation; venom; pit viper; snake envenoming
- Identifier
- http://hdl.handle.net/1959.13/1302772
- Identifier
- uon:20541
- Identifier
- ISSN:1879-3150
- Language
- eng
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