yamakagashi bite
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Furthermore, his fibrinogen levels increased to >100 mg/dL, while his thrombin–antithrombin III complex, plasmin–alpha 2‐plasmin inhibitor complex, and fibrinogen degradation product levels normalized. Yamakagashi (Rhabdophis tigrinus) bites induce life-threatening hemorrhagic symptoms and severe disseminated intravascular coagulation with a fibrinolytic phenotype, resulting in hypofibrinogenemia and increased levels of fibrinogen degradation products. Chudoku kenkyu, A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria, Classifying types of disseminated intravascular coagulation: clinical and animal models, Disseminated intravascular coagulation in acute leukemia, Trauma, shock, and disseminated intravascular coagulation: lessons from the classical literature.
However, because R. tigrinus antivenom only neutralizes the unbound venom, and cannot restore organ function, antivenom should be given as early as possible. 0000174658 00000 n
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In the current case, antivenom was given 28 h after the R. tigrinus bites with completely recovery. 0000072862 00000 n
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; and respiratory rate, 12 breaths/min. The patient's laboratory data revealed severe coagulopathy (Table 1), particularly severe hypofibrinogenemia. His fibrinogen level increased to >100 mg/dL, while his TAT, PIC, and FDP levels normalized. Although R. tigrinusvenom is known to induce life-threatening hemorrhagic symptoms, the clinical characteristics and effective treatment of R. tigrinusbites remain unknown. The patient was subsequently admitted to emergency hospital for treatment. 0000073102 00000 n
The present study aimed to clarify these issues. 0000082588 00000 n
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Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, I have read and accept the Wiley Online Library Terms and Conditions of Use, Experimental manufacture of equine antivenom against yamakagashi (, Characterization of a novel metalloproteinase in Duvernoy's gland of, Clinical characteristics of Yamakagashi (, Surveillance of the clinical use of mamushi (, Diagnosis and treatment of snakebite by Mamushi and Yamakagashi. If you do not receive an email within 10 minutes, your email address may not be registered, "�iRR��Ρ���D�?���GڄitJC��" �&�C��D�zg���TȚ���y�S�}F�fb�+��j�b�Xta��}I^�9h���ȕ*��Yr�]���V�с 0000172375 00000 n
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Antivenom was given 28 h after the patient was bitten, following which his hemorrhagic symptoms resolved. 0000086453 00000 n
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Moreover, plasminogen activator inhibitor‐1, which induces fibrinolysis suppression, was not evaluated. 0000071276 00000 n
Working off-campus?
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Antivenom from the Chemo‐Sero‐Therapeutic Research Institute (Kaketsuken; Kumamoto, Japan; Fig. It appears that R. tigrinus antivenom can result in normalization of coagulation markers as well as clinical recovery without the development of multiple organ dysfunction syndrome, even in the presence of severe DIC. 0000003608 00000 n
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Introduction Yamakagashi (Rhabdophis tigrinus ), mamushi ( Gloydius blomhoffii ), and habu ( Protobothrops flavoviridis ) are venomous snakes in Japan.
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A healthy 40‐year‐old man was admitted with severe coagulopathy that developed after Rhabdophis tigrinus bites. 0000087546 00000 n
Rhabdophis tigrinus bites induced DIC with a fibrinolytic phenotype, which completely recovered with antivenom treatment. �ޘȢڗ5���y4"��j��U�;m�PA���� Our current case developed markedly elevated TAT, PIC, and FDP levels on admission. Although the safety is examined, we recommend that premedication with antihistaminics and steroids should be considered for anaphylaxis. Epidemiological profile and outcomes of snakebite injuries treated in emergency departments in South Korea, 2011–2016: a descriptive study. Yamakagashi (Rhabdophis tigrinus) bites induce life-threatening hemorrhagic symptoms and severe disseminated intravascular coagulation with a fibrinolytic phenotype, resulting in hypofibrinogenemia and increased levels of fibrinogen degradation products. trailer
It is present throughout … By day 3 of admission, scabs had formed over the bite wounds. Rhabdophis tigrinus is a rear‐fanged venomous snake often found in paddy fields.1 Its venom shows strong plasma coagulant activity, with prothrombin activating effects and weak thrombin‐like effects that result in hemorrhagic symptoms.2 Because this snake has no grooved fangs, envenomation does not occur in most bites; therefore, this snake has long been considered non‐venomous.1 Although R. tigrinus bites induces life‐threatening injuries, their mechanism and treatment have not been examined because of the extremely rare incidence of severe cases (nine cases reported over the past 13 years), compared with that of bites from G. blomhoffii and P. flavoviridis.1, 3, 4, Our former survey indicated that the pathophysiology of R. tigrinus bites was considered disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype; however, the details of coagulation markers remain unknown. The patient was discharged on day 6 of admission and was followed‐up for 1 month, during which no clinical symptoms representing serum sickness were observed.
Learn more. 0000069431 00000 n
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A 40‐year‐old man with no significant past medical history was bitten on his left hand by a snake while fishing in a river in the afternoon. 0000173666 00000 n
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No anaphylactic reaction was observed. 0000004768 00000 n
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Although R. tigrinus venom is known to induce life-threatening hemorrhagic symptoms, the clinical characteristics and effective treatment of R. tigrinus bites remain unknown. Learn about our remote access options, Emergency Medical Center, Kagawa University Hospital, Kagawa, Japan, Department of Internal Medicine, Kaizuka Hospital, Fukuoka, Japan, The Chemo‐Sero‐Therapeutic Research Institute, Kumamoto, Japan, Department of Bacteriology II, National Institute of Infectious Disease, Tokyo, Japan, Department of Immunology, National Institute of Infectious Disease, Tokyo, Japan, Division of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Tokyo, Japan. 0000144386 00000 n
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Y�$`%��1�B�}Q�N�3T. 0000172414 00000 n
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First, because tissue plasminogen activator was not evaluated, the modes of primary fibrinogenolysis activation remain unclear. 3). On day 2 of admission (16 h after antivenom treatment), the bleeding from the wound site subsided. 0000071991 00000 n
Transactions of The Royal Society of Tropical Medicine and Hygiene. 0000072148 00000 n
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The present study aimed to clarify these issues. 0000093228 00000 n
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Yamakagashi (Rhabdophis tigrinus) antivenom. 0000073460 00000 n
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Although R. tigrinus antivenom is considered a definitive and effective treatment, it was not approved for clinical use and was only experimentally manufactured by a regional health laboratory in 2000. 0000083923 00000 n
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Petechiae were observed on the tip of his nose and right cheek. 0000113032 00000 n
By day 3 of admission, scabs had formed over the wounds (Fig. 0000152987 00000 n
One hour later, one vial of antivenom was administered to the patient following premedication with antihistaminics and steroids. The Most Dangerous Snakes : The Yamakagashi or Tiger Keelback Snake ( Rhabdophis tigrinus ) ! Although his left hand was bleeding, no epistaxis or hematuria was observed. 0000087184 00000 n
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(Yamakagashi snake) envenomation 0000087931 00000 n
Background. Trends of coagulation markers in a 40‐year‐old man admitted with severe coagulopathy that developed after Rhabdophis tigrinus bites. 0000093120 00000 n
His oxygen saturation was 100% while breathing room air. 0000079994 00000 n
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Rhabdophis tigrinus bites induced disseminated intravascular coagulation with a fibrinolytic phenotype, which completely recovered with antivenom treatment. 0000002796 00000 n
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Therefore, antivenom therapy should be considered for patients with R. tigrinus bites. He was discharged on day 6 of admission. Early pathology in venom-induced consumption coagulopathy by startxref
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0
We carried out an in vitro examination regarding the effectiveness and safety of antivenom, and confirmed that the quality of antivenom has not been changed for the past 13 years. 0000175783 00000 n
AMY, amylase; APTT, activated partial thromboplastin time; AT‐III, antithrombin‐III; BUN, blood urea nitrogen; Ca, calcium; Cl, chloride; Cr, creatinine; FDP, fibrinogen degradation products; GLU, glucose; K, potassium; Na, sodium; ODL, over detection limit; Plt, platelet; PT, prothrombin time; TB, total bilirubin; TP, total protein. In the current patient, although the levels of coagulation markers were markedly elevated on admission, they normalized promptly following antivenom treatment. Yamakagashi ( Rhabdophis tigrinus) is a species of pit viper. However, because of the uncommon incidence of bites and tendency for late development of symptoms/signs, the early effects of the venom on the coagulation system are poorly known. Asakura reported that severely elevated makers indicate DIC, particularly DIC with enhanced fibrinolysis (fibrinolytic phenotype),7 which is observed in patients with severe blunt trauma in the acute phase8 or acute leukemia, particularly acute promyelocytic leukemia.9 We realized that the pathophysiology of R. tigrinus bites in acute phase is DIC with enhanced fibrinolysis (fibrinolytic phenotype) by the examination of coagulation markers, such as TAT, PIC, and FDP. b�\>��������q�2�6t�7Z�'��vb)�_����:p�[��BH�G�7mCP��+��T�=b�P�:+Y��k{�դ28�93Xf�����MY^����1���/> 0000152461 00000 n
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We described a case of R. tigrinus bites that completely recovered following antivenom treatment in a 40‐year‐old patient who developed DIC accompanied by bleeding manifestations secondary to the bites. The patient's clinical course and trends of coagulation markers are shown in Figure 1. Journal of the Japanese Society of Intensive Care Medicine. 0000073022 00000 n
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Abstract. 0000117522 00000 n
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It was freeze‐dried to maintain its initial potency for longer periods. 0000093075 00000 n
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Nine hours after he was bitten, his left hand became tender and swollen, and another 3 h later, he began to bleed from the wound site. 0000175452 00000 n
Number of times cited according to CrossRef: Diagnosis of acute intoxications in critically ill patients: focus on biomarkers – part 2: markers for specific intoxications. However, the bleeding persisted and petechiae developed; therefore, he visited the hospital again the following day. 0000105320 00000 n
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Complete hemostasis was achieved 24 h after treatment.
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