An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia
In this case report the hospital management of an acute, severe thrombocytopenia in a 57-year-old man in the north-east of Italy is reported. Thrombocytopenia developed immediately after the viper bite, despite the absence of clinical signs of envenomation. No hemorrhage, ecchymoses or other signs o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Toxicology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214750022000609 |
| _version_ | 1811188701628203008 |
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| author | Matteo Turetta Fabio Del Ben Donatella Londero Agostino Steffan Pierpaolo Pillinini |
| author_facet | Matteo Turetta Fabio Del Ben Donatella Londero Agostino Steffan Pierpaolo Pillinini |
| author_sort | Matteo Turetta |
| collection | DOAJ |
| description | In this case report the hospital management of an acute, severe thrombocytopenia in a 57-year-old man in the north-east of Italy is reported. Thrombocytopenia developed immediately after the viper bite, despite the absence of clinical signs of envenomation. No hemorrhage, ecchymoses or other signs of coagulopathy developed during the hospitalization; two doses of antivenin FAB–Fragments had no effect on thrombocytopenia, which instead responded promptly to intravenous immunoglobulins (IVIg) and glucocorticoids. Direct and indirect anti-platelet antibodies against anti-GP IIb/IIIa and Ia/IIa were detected during the treatment and turned negative after 20 weeks. The rationale of such off-label treatment is the interpretation of the thrombocytopenia as a venom-induced immune thrombocytopenia which led to splenic sequestration of platelets. To our knowledge, there is no literature about venom-induced immune thrombocytopenia against GP IIb/IIIa and Ia/IIa protein in European countries and subsequent response to IVIg and corticosteroids. |
| first_indexed | 2024-04-11T14:22:51Z |
| format | Article |
| id | doaj.art-fa7121639c0d463ebe40d79898caa7cd |
| institution | Directory Open Access Journal |
| issn | 2214-7500 |
| language | English |
| last_indexed | 2024-04-11T14:22:51Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Toxicology Reports |
| spelling | doaj.art-fa7121639c0d463ebe40d79898caa7cd2022-12-22T04:19:00ZengElsevierToxicology Reports2214-75002022-01-019636639An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopeniaMatteo Turetta0Fabio Del Ben1Donatella Londero2Agostino Steffan3Pierpaolo Pillinini4Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Medical Area, University of Udine, ItalyImmunohematology Laboratory, Azienda Sanitaria Universitaria Friuli Centrale, Udine, ItalyImmunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Corresponding author.Department of Emergency Medicine, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, ItalyIn this case report the hospital management of an acute, severe thrombocytopenia in a 57-year-old man in the north-east of Italy is reported. Thrombocytopenia developed immediately after the viper bite, despite the absence of clinical signs of envenomation. No hemorrhage, ecchymoses or other signs of coagulopathy developed during the hospitalization; two doses of antivenin FAB–Fragments had no effect on thrombocytopenia, which instead responded promptly to intravenous immunoglobulins (IVIg) and glucocorticoids. Direct and indirect anti-platelet antibodies against anti-GP IIb/IIIa and Ia/IIa were detected during the treatment and turned negative after 20 weeks. The rationale of such off-label treatment is the interpretation of the thrombocytopenia as a venom-induced immune thrombocytopenia which led to splenic sequestration of platelets. To our knowledge, there is no literature about venom-induced immune thrombocytopenia against GP IIb/IIIa and Ia/IIa protein in European countries and subsequent response to IVIg and corticosteroids.http://www.sciencedirect.com/science/article/pii/S2214750022000609Viper biteIntravenous immunoglobulinsThrombocytopeniaGlucocorticoids |
| spellingShingle | Matteo Turetta Fabio Del Ben Donatella Londero Agostino Steffan Pierpaolo Pillinini An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia Toxicology Reports Viper bite Intravenous immunoglobulins Thrombocytopenia Glucocorticoids |
| title | An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia |
| title_full | An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia |
| title_fullStr | An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia |
| title_full_unstemmed | An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia |
| title_short | An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia |
| title_sort | antivenin resistant ivig corticosteroids responsive viper induced thrombocytopenia |
| topic | Viper bite Intravenous immunoglobulins Thrombocytopenia Glucocorticoids |
| url | http://www.sciencedirect.com/science/article/pii/S2214750022000609 |
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