title: Accident involving a 2-year-old child and Lonomia obliqua venom: clinical and coagulation abnormalities.
abstract: Poisons of caterpillars have different effects on inflammatory and coagulation systems. This is a case report of a 2-year-old child that accidentally came in contact with several caterpillars of the species Lonomia obliqua. At first, the patient's exams presented abnormal coagulation and decreased fibrinogen, but the patient did not evolve to active bleeding or acute renal failure. The patient received antilonomic serum 15h after the accident and the treatment was repeated after another 12h due to persistent alterations shown by the coagulation exams. The venom of L. obliqua has several substances that act on the coagulation and inflammatory systems. The event is characterized by a hemorrhagic syndrome with decreases in fibrinogen. L. obliqua Stuart-factor activator (Losac) and L. obliqua prothrombin activator protease (Lopap) are components that act with procoagulatory effects. The pro-inflammatory action occurs due to metalloproteases, hyaluronidases and other substances with inflammatory activity. Studies on caterpillar venom can give new perspectives on the treatment of cancer and other diseases that cause dysfunction of the extra-cellular matrix.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; ḾBoi Mirim, Hospital Municipal Dr. Moisés Deutsch, São Paulo, SP, Brazil. Electronic address: daninasu@gmail.com.
authors.forename: Daniela Nasu Monteiro
authors.initials: DN
authors.lastname: Medeiros
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Hélida Conceição Cavalcante
authors.initials: HC
authors.lastname: Torres
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Eduarto Juan
authors.initials: EJ
authors.lastname: Troster
keywords: Accident; Child; Disseminated intravascular coagulation