title: Blood coagulation and fibrinolytic factors in 105 patients with hemorrhagic syndrome caused by accidental contact with Lonomia obliqua caterpillar in Santa Catarina, southern Brazil.
abstract: Haemostatic disorders caused by Lonomia obliqua caterpillars has reached epidemic proportions in southern Brazil. Here we evaluated coagulation and fibrinolysis in 105 patients after accidental contact with Lonomia obliqua caterpillars. Global coagulation tests were prolonged in most cases and patients were divided into 3 groups according to fibrinogen (Fg) level: <or=0.5 g/l (group A); 0.51-1.5 g/l (group B), >1.5 g/l (group C). There was a significant reduction of factors V, XIII, VIII and prekallikrein in group A, with no change in factors X, II and von Willebrand factor. Thrombin-antithrombin and prothrombin F1+2 were elevated in most patients. Antithrombin and protein S were not changed whereas protein C levels were reduced in group A. Plasminogen and alfa2-antiplasmin levels were significantly reduced in group A and D-Dimer levels were extremely high in all groups, showing that fibrinolysis had been activated, possibly secondary to fibrin production. Levels of t-PA were normal and PAI-1 was mildly elevated in group A. The platelet count remained above 150 x 109 platelets/ml in 97% of cases. In summary, our results suggest that Lonomia obliqua envenoming is characterized by a consumption coagulopathy and secondary fibrinolysis.
authors.affiliation: Department of Pathology and Toxicology UFSC Florianópolis SC.
authors.forename: Marlene
authors.initials: M
authors.lastname: Zannin
authors.forename: Dayse M
authors.initials: DM
authors.lastname: Lourenço
authors.forename: Guacyara
authors.initials: G
authors.lastname: Motta
authors.forename: Luis R
authors.initials: LR
authors.lastname: Dalla Costa
authors.forename: Margaret
authors.initials: M
authors.lastname: Grando
authors.forename: Geni P
authors.initials: GP
authors.lastname: Gamborgi
authors.forename: Maria A
authors.initials: MA
authors.lastname: Noguti
authors.forename: Ana M
authors.initials: AM
authors.lastname: Chudzinski-Tavassi
mesh_terms: D000818:Animals; D000990:Antithrombin III / Q000032:analysis; D001180:Arthropod Venoms / Q000009:adverse effects*; D015415:Biomarkers; D001779:Blood Coagulation Factors / Q000032:analysis; D001780:Blood Coagulation Tests; D001798:Blood Proteins / Q000032:analysis*; D001938:Brazil; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000209:etiology; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006470:Hemorrhage / Q000097:blood / Q000209:etiology*; D006801:Humans; D007814:Larva; D009036:Moths / Q000254:growth & development; D010447:Peptide Hydrolases / Q000032:analysis; D010976:Platelet Count; D012697:Serine Endopeptidases / Q000009:adverse effects
chemical_list: D001180:Arthropod Venoms; D015415:Biomarkers; D001779:Blood Coagulation Factors; D001798:Blood Proteins; D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D010447:Peptide Hydrolases; C119835:Lonomia obliqua prothrombin activator protease; D012697:Serine Endopeptidases