title: The action of Russell's viper venom on fibrin formation and fibrinolysis in vivo.
abstract: Envenoming by Russell's viper caused a marked rise in FPA, B beta 15-42 fragment and fibrin derived cross-linked D-dimer fragment indicative of a consumptive coagulopathy with hyperfibrinolysis. There was no increase in tPA or tPA-I levels post envenoming, which suggests that the increase in fibrinolytic activity was not due to venom-induced release of tPA from the vessel walls but may have been attributable to a direct effect of the venom or to a secondary physiological response to fibrin deposition. The effectiveness of the antivenom is demonstrated by its ability to prevent further cleavage of fibrinogen and the return to normal fibrinogen levels by 24 h. A secondary rise in FPA at this time indicates that the initial dose of antivenom may have been too small. The antivenom alone or in combination with the venom causes the release of tPA, tPA-I and vWF by the vessel walls. This may be a consequence of the severe anaphylactic reactions seen in some patients.
authors.affiliation: Katharine Dormandy Haemophilia Centre, Royal Free Hospital, London, U.K.
authors.forename: B J
authors.initials: BJ
authors.lastname: Woodhams
authors.forename: T
authors.initials: T
authors.lastname: Than
authors.forename: T
authors.initials: T
authors.lastname: Than
authors.forename: R A
authors.initials: RA
authors.lastname: Hutton
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005337:Fibrin / Q000096:biosynthesis*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000187:drug effects*; D005344:Fibrinopeptide A / Q000032:analysis; D005345:Fibrinopeptide B / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D012909:Snake Bites / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood; D014757:Viper Venoms / Q000009:adverse effects*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D014757:Viper Venoms; C036309:fibrin fragment D; C033786:fibrinogen Bbeta (15-42); D005344:Fibrinopeptide A; D005345:Fibrinopeptide B; D005337:Fibrin; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator