Human anti-snake venom IgG antibodies in a previously bitten snake-handler, but no protection against local envenoming.
We report a 60 year old male bitten by snakes from the Acanthophis genus (Death adder) on two occasions who developed high titres of human IgG antibodies to Acanthophis venom detected at the time of the second bite. The patient was bitten by Acanthophis antarcticus (common death adder) on the first occasion, developed non-specific systemic effects and did not receive antivenom. Three months later he was bitten by Acanthophis praelongus (northern death adder) and he developed significant local myotoxicity associated with a moderate rise in the creatine kinase (maximum 4770 U/L). He was given antivenom 55 h after the bite and recovered over several days. Death adder venom was detected in serum at the time of the first bite, but not the second bite. Human IgG antibodies to death adder were detected on the second admission but not the first. However, despite the presence of antibodies to death adder venom and free venom not being detected, the patient still developed significant local myotoxicity.
Isbister
Geoffrey K
GK
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, New South Wales, Australia. geoffrey.isbister@menzies.edu.au
Halkidis
Lambros
L
O'Leary
Margaret A
MA
Whitaker
Richard
R
Cullen
Paul
P
Mulcahy
Richard
R
Bonnin
Robert
R
Brown
Simon G A
SG
D000818:Animals; D000997:Antivenins / Q000097:blood* / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004487:Edema / Q000209:etiology / Q000628:therapy; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D010146:Pain / Q000209:etiology; D059408:Pain Management; D012909:Snake Bites / Q000276:immunology* / Q000628:therapy; D012910:Snake Venoms / Q000276:immunology*; D017819:Viperidae / Q000502:physiology
D000997:Antivenins; D007074:Immunoglobulin G; D012910:Snake Venoms; D003402:Creatine Kinase