Report of two cases: Rattlesnake venom-induced thrombocytopenia.
We report 2 patients who presented with vasomotor symptoms and severe thrombocytopenia following rattlesnake bites. These symptoms persisted in spite of treatment with antivenin and transfusion of multiple doses of platelets. Thrombocytopenia is a common occurrence in moderate to severe crotaline envenomation. Algorithms suggested for the treatment of rattlesnake envenomation with crotaline-specific antivenin may not reverse the associated thrombocytopenia. The precise mechanism of venom-induced thrombocytopenia (VIT), even in the absence of significant coagulopathy, is unknown. Our experience suggests that, unless spontaneous bleeding occurs, repeated transfusion of fresh frozen plasma and/or platelets may not be indicated.
Odeleye
Abiodun A
AA
Department of Pathology, University of Virginia Heath System, Charlottesville, Virginia 22908, USA.
Presley
Ali E
AE
Passwater
Michael E
ME
Mintz
Paul D
PD
D000328:Adult; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D003435:Crotalid Venoms / Q000506:poisoning*; D017839:Crotalus; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments / Q000627:therapeutic use; D008297:Male; D017713:Platelet Transfusion; D012909:Snake Bites / Q000150:complications* / Q000473:pathology / Q000628:therapy; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy
D000997:Antivenins; D003435:Crotalid Venoms; C431183:Crotalidae Polyvalent immune Fab; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments