Bleeding Disorders inBothrops atroxEnvenomations in the Brazilian Amazon: Participation of Hemostatic Factors and the Impact of Tissue Factor

Author(s):Show less -

S. Oliveira, Samella ^{[1, 2]} ; C. Alves, Eliane ^{[1, 2]} ; S. Santos, Alessandra ^[1] ; F. Nascimento, Elizandra ^[1] ; T. Pereira, Joao Pedro ^[1] ; M. Silva, Iran ^{[1, 2]} ; A. G. Sachett, Jacqueline ^{[1, 2]} ; S. Sarraff, Lybia Kassia ^[1] ; Freitas-de-Sousa, Luciana Aparecida ^[3] ; Colombini, Monica ^[3] ; O. Marques, Hedylamar ^[4] ; V. G. Lacerda, Marcus ^[1] ; Sartim, Marco Aurelio ^[5] ; Moura-da-Silva, Ana Maria ^{[3, 1]} ; L. Ferreira, Luiz Carlos ^[1] ; S. Sano-Martins, Ida ^[6] ; M. Monteiro, Wuelton ^{[1, 2]}

Affiliation

^[1] Dr Heitor Vieira Dourado Trop Med Fdn, Carlos Borborema Clin Res Inst, BR-69040000 Manaus, Amazonas - Brazil

^[2] Amazonas State Univ, Sch Hlth Sci, BR-69065001 Manaus, Amazonas - Brazil

^[3] Butantan Inst, Immunopathol Lab, BR-05503900 Sao Paulo - Brazil

^[4] Amazonas State Hematol & Haemotherapy Hosp Fdn, Hemostasis Lab, BR-69050001 Manaus, Amazonas - Brazil

^[5] Univ Fed Amazonas, Inst Biol Sci, BR-69070000 Manaus, Amazonas - Brazil

^[6] Butantan Inst, Pathophysiol Lab, BR-05503900 Sao Paulo - Brazil

• Document type: Journal article
• Source: TOXINS; v. 12, n. 9 SEP 2020.
• Web of Science Citations: 0

Abstract

Bleeding is a common hemostatic disorder that occurs inBothropsenvenomations. We evaluated the changes in coagulation, fibrinolysis components, and platelets inBothrops atroxenvenomations with bleeding. This is an observational study withB. atroxsnakebite patients (n= 100) treated in Manaus, Brazilian Amazon. Bleeding was recorded on admission and during hospitalization. We found that the platelet count in our patients presented a weak correlation to tissue factor, factor II, and plasminogen. Tissue factor presented weak correlation to factor V, II, D-dimer, plasminogen, alpha 2-antiplasmin, and moderate correlation to fibrinogen and fibrin/fibrinogen degradation product (FDP). Patients with systemic bleeding (n= 20) presented low levels of factor V, II, fibrinogen, plasminogen, and alpha 2-antiplasmin, and high levels of tissue factor and FDP compared to those without bleeding. Patients with only local bleeding (n= 41) and without bleeding showed similar levels of hemostatic factors. Thrombocytopenia was observed mainly in patients with systemic bleeding and increased levels of serum venom. No association was found between venom levels and systemic bleeding, or between venom levels and clinical severity of envenomation. This is the first report that shows the participation of the extrinsic coagulation pathway in the consumption coagulopathy ofB. atroxenvenomations with systemic bleeding due to tissue factor release. (AU)

• FAPESP's process: 17/24546-3 - Scales of biodiversity: integrated studies of snake evolution and venom function
• Grantee: Luciana Aparecida Freitas de Sousa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral