title: Antivenom treatment in Vipera berus envenoming--report of 30 cases.
abstract: OBJECTIVE
  To assess efficacy and safety of two equine F(ab')2 antivenoms currently used to treat envenoming by European vipers.
  
  
  METHODS
  Retrospective case review study.
  
  
  METHODS
  Case records collected by the Swedish Poison Information Centre concerning patients treated in Swedish hospitals for bites by the common European adder, Vipera berus.
  
  
  METHODS
  Patients presenting with V. berus envenoming treated with antivenom (n = 30) and two groups of patients not given antivenom (n = 16 and n = 38).
  
  
  METHODS
  Clinical course and time in hospital were retrospectively studied and compared in patients treated or not treated with antivenom.
  
  
  RESULTS
  There was a significantly lower incidence of extensive oedema (23 vs. 88%) and anaemia (10 vs. 50%) in the antivenom-treated group, and the hospital stay was shorter (median: 3 vs. 6 days). Antivenom treatment also resulted in prompt clinical improvement in the acute phase. Adverse effects consisting of urticaria and serum sickness occurred in 10% of the patients given antivenom.
  
  
  CONCLUSIONS
  Antivenom treatment was associated with a reduced morbidity in severe V. berus envenoming. However, the occurrence of allergic side-effects is not negligible with this type of antivenom.
authors.affiliation: Swedish Poison Information Centre, Stockholm.
authors.forename: C
authors.initials: C
authors.lastname: Karlson-Stiber
authors.forename: H
authors.initials: H
authors.lastname: Persson
mesh_terms: D000293:Adolescent; D000328:Adult; D000997:Antivenins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012909:Snake Bites / Q000503:physiopathology / Q000628:therapy*; D013548:Sweden; D016896:Treatment Outcome; D014757:Viper Venoms / Q000037:antagonists & inhibitors* / Q000506:poisoning
chemical_list: D000997:Antivenins; D007140:Immunoglobulin Fab Fragments; D014757:Viper Venoms