Antivenom treatment in Vipera berus envenoming--report of 30 cases.
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.
Karlson-Stiber
C
C
Swedish Poison Information Centre, Stockholm.
Persson
H
H
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
D000997:Antivenins; D007140:Immunoglobulin Fab Fragments; D014757:Viper Venoms