Multiple Thrombotic Occlusions of Vessels after Russell's Viper Envenoming
Dong-Zong Hung
Institutes of Toxicology and
Division of Toxicology, Emergency Department, Taichung Veterans General Hospital, Taichung and
Search for more papers by this authorMing-Ling Wu
Division of Clinical Toxicology, Medical Department, Veterans General Hospital, Taipei, Taiwan
Search for more papers by this authorJou-Fang Deng
Division of Clinical Toxicology, Medical Department, Veterans General Hospital, Taipei, Taiwan
Search for more papers by this authorDar-Yu Yang
Division of Toxicology, Emergency Department, Taichung Veterans General Hospital, Taichung and
Search for more papers by this authorShoei-Yn Lin-Shiau
Institutes of Toxicology and
Pharmacology, School of Medicine, National Taiwan University;
Search for more papers by this authorDong-Zong Hung
Institutes of Toxicology and
Division of Toxicology, Emergency Department, Taichung Veterans General Hospital, Taichung and
Search for more papers by this authorMing-Ling Wu
Division of Clinical Toxicology, Medical Department, Veterans General Hospital, Taipei, Taiwan
Search for more papers by this authorJou-Fang Deng
Division of Clinical Toxicology, Medical Department, Veterans General Hospital, Taipei, Taiwan
Search for more papers by this authorDar-Yu Yang
Division of Toxicology, Emergency Department, Taichung Veterans General Hospital, Taichung and
Search for more papers by this authorShoei-Yn Lin-Shiau
Institutes of Toxicology and
Pharmacology, School of Medicine, National Taiwan University;
Search for more papers by this authorAbstract
Abstract: Systemic bleeding due to consumption coagulopathy and thrombocytopenia due to activation of procoagulants is the leading manifestation and cause of death in Russell's viper systemic envenoming. Thrombotic occlusion of the blood vessels is rare in cases of snakebite. In this report, two adult patients with Russell's viper systemic envenoming presented multiple cerebral infarctions, digital gangrenes and ischaemic organs in addition to typical clinical manifestations of bleeding diathesis and renal involvement. Our findings in these two special cases suggest that the venom-induced coagulopathy and endothelium damage, predisposed by toxin-induced vasoconstriction, might be the possible mechanism of multiple thrombotic vascular occlusions in systemic envenoming of Formosan Russell's viper.
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