Comparative evaluation of adverse effects in the use of powder trivalent antivenom and liquid antivenoms in Bothrops snake bites.

Instituto de Biologia do Exército, Rio de Janeiro, RJ, Brasil.
Revista da Sociedade Brasileira de Medicina Tropical (Impact Factor: 0.93). 08/2012; 45(4):523-5. DOI: 10.1590/S0037-86822012000400022
Source: PubMed

ABSTRACT Snake bite, a problem in public health, generally occurs where there is no electric power.
A comparative clinical study was conducted with 102 victims of Bothrops snake bite, from the state of Amazonas, Brazil; 58 victims were treated with liofilizated trivalent antivenom serum (SATL) and 44 victims treated with liquid bivalent and monovalent antivenom serum (SAMBL).
17% (10/58) of patients presented adverse effects with the SATL and 25% (11/44) with the SAMBL.
There was no statistic difference in number of adverse effects between the two types of snake bite antivenom.

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    ABSTRACT: Snake antivenoms are formulations of immunoglobulins, or immunoglobulin fragments, purified from the plasma of animals immunized with snake venoms. Their therapeutic success lies in their ability to mitigate the progress of toxic effects induced by snake venom components, when administered intravenously. However, due to diverse factors, such as deficient manufacturing practices, physicochemical characteristics of formulations, or inherent properties of heterologous immunoglobulins, antivenoms can induce undesirable adverse reactions. Based on the time lapse between antivenom administration and the onset of clinical manifestations, the World Health Organization has classified these adverse reactions as: 1- Early reactions, if they occur within the first hours after antivenom infusion, or 2- late reactions, when occurring between 5 and 20 days after treatment. While all late reactions are mediated by IgM or IgG antibodies raised in the patient against antivenom proteins, and the consequent formation of immune complexes, several mechanisms may be responsible for the early reactions, such as pyrogenic reactions, IgE-mediated reactions, or non IgE-mediated reactions. This work reviews the hypotheses that have been proposed to explain the mechanisms involved in these adverse reactions to antivenoms. The understanding of these pathogenic mechanisms is necessary for the development of safer products and for the improvement of snakebite envenomation treatment.
    Toxicon 09/2013; · 2.58 Impact Factor


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