Afibrinogenemia following snake bite (Crotalus durissus terrificus)

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: C. F. S. Amaral, N. A. Rezende, T. M. G. Pedrosa, O. A. da Silva, E. R. P. Pedroso
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1988
• Subjects: Afibrinogenemia; Acidente ofídico crotálico; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46651988000400007; https://doaj.org/article/13db4cc0b6e34151a03e171acf9c48a6

This paper reports two cases of afibrinogenemia with normal platelet count following Crotalus durissus terrificus, snake bite Both patients presented high output acute renal failure and case two also had increased blood levels of CPK and LDH compatible with the diagnosis of rhabdomyolysis. Case one was given an unknown amount of antivenom and was treated with epsilonaminocaproic acid and a fresh whole blood transfusion and showed recovery of the coagulation disturbance 40 hours following these measures. Case two was given an adequate amount of crotalide antivenom and the coagulation tests performed 12 hours later showed a normal partial thromboplastin time and fibrinogen 86 mg/100ml. Case one presented no haemorrhagic disturbances. Case two presented persistent bleeding following venopuncture and after removal of impetigo crust in the legs. Acute renal failure was treated conservatively and both patients were discharged from the hospital with recovery of the renal function.