Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/343054
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dc.contributor.CRUESPUNIVERSIDADE ESTADUAL DE CAMPINASpt_BR
dc.contributor.authorunicampBucaretchi, Fabio-
dc.contributor.authorunicampPimenta, Maíra Migliari Branco-
dc.contributor.authorunicampBorrasca-Fernandes, Carla Fernanda-
dc.contributor.authorunicampPrado, Camila Carbone-
dc.contributor.authorunicampDe Capitani, Eduardo Mello-
dc.contributor.authorunicampHyslop, Stephen-
dc.typeArtigopt_BR
dc.titleThrombotic microangiopathy following Bothrops jararaca snakebite: case reportpt_BR
dc.contributor.authorBucaretchi, Fabio-
dc.contributor.authorPimenta, Maira M. Branco-
dc.contributor.authorBorrasca-Fernandes, Carla F.-
dc.contributor.authorPrado, Camila Carbone-
dc.contributor.authorCapitani, Eduardo Mello De-
dc.contributor.authorHyslop, Stephen-
dc.subjectBothrops jararacapt_BR
dc.subject.otherlanguageBothrops jararacapt_BR
dc.description.abstractThrombotic microangiopathy (TMA) is an uncommon and severe complication of snakebites, and is similar, in general, to hemolytic-uremic syndrome (HUS). We describe a case of TMA following envenomation by Bothrops jararaca. Case details: A 56-y-old-woman with controlled hypertension was transferred from a primary hospital to our ER similar to 7 h after being bitten by B. jararaca in the distal left leg. She developed edema extending from the bite site to the proximal thigh, associated with intense radiating local pain, local paresthesia and ecchymosis at the bite site. Laboratory features upon admission revealed coagulopathy (20 min whole blood clotting time - WBCT20 > 20 min), thrombocytopenia (76,000 platelets/mm(3)) and slight increase in serum creatinine (1.58 mg/dL; RV < 1.2 mg/dL). Upon admission, the patient was treated with bothropic antivenom and fluids replacement. During evolution, her thrombocytopenia and anemia worsened, with blood films showing fragmented red cells, haptoglobin consumption, increase in serum lactate dehydrogenase, and progressive increase of serum creatinine (KDIGO stage = 3). No RBC transfusion, renal replacement therapy or plasmapheresis was done. The patient showed progressive improvement from day nine (D9) onwards and was discharged on D20; there was complete recovery of hemoglobin levels at follow-up (D50). ADAMTS-13 activity, assayed 10 months post-bite, was within reference values. Discussion: TMA following snakebite has been reported mainly in India, Sri Lanka and Australia, with several patients needing renal replacement therapy. Although controversial, plasmapheresis has also been used in some cases. Our patient developed microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury, a triad of features compatible with TMA similar to HUS. Despite the severity, the outcome following conservative treatment was good, with complete recoverypt_BR
dc.relation.ispartofClinical toxicologypt_BR
dc.relation.ispartofabbreviationClin. toxicol.pt_BR
dc.publisher.cityPhiladelphia, PApt_BR
dc.publisher.countryEstados Unidospt_BR
dc.publisherTaylor & Francispt_BR
dc.date.issued2019-
dc.date.monthofcirculationApr.pt_BR
dc.language.isoengpt_BR
dc.description.volume57pt_BR
dc.description.issuenumber4pt_BR
dc.description.firstpage294pt_BR
dc.description.lastpage299pt_BR
dc.rightsFechadopt_BR
dc.sourceWOSpt_BR
dc.identifier.issn1556-3650pt_BR
dc.identifier.eissn1556-9519pt_BR
dc.identifier.doi10.1080/15563650.2018.1514621pt_BR
dc.identifier.urlhttps://www.tandfonline.com/doi/abs/10.1080/15563650.2018.1514621pt_BR
dc.date.available2020-06-09T23:13:58Z-
dc.date.accessioned2020-06-09T23:13:58Z-
dc.description.provenanceSubmitted by Thais de Brito Barroso (tbrito@unicamp.br) on 2020-06-09T23:13:58Z No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2020-06-09T23:13:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2019en
dc.identifier.urihttp://repositorio.unicamp.br/jspui/handle/REPOSIP/343054-
dc.contributor.departmentDepartamento de Pediatriapt_BR
dc.contributor.departmentSem informaçãopt_BR
dc.contributor.departmentSem informaçãopt_BR
dc.contributor.departmentSem informaçãopt_BR
dc.contributor.departmentDepartamento de Clínica Médicapt_BR
dc.contributor.departmentDepartamento de Farmacologiapt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.subject.keywordEnvenomationpt_BR
dc.subject.keywordHemolytic-uremic syndromept_BR
dc.subject.keywordSnakebitept_BR
dc.subject.keywordThrombotic microangiopathypt_BR
dc.identifier.source000463838400011pt_BR
dc.creator.orcid0000-0003-2988-7330pt_BR
dc.creator.orcidSem informaçãopt_BR
dc.creator.orcid0000-0003-4702-1952pt_BR
dc.creator.orcidSem informaçãopt_BR
dc.creator.orcid0000-0001-5286-6971pt_BR
dc.creator.orcid0000-0002-9293-3638pt_BR
dc.type.formComunicaçãopt_BR
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