Fibrinolysis as a feature of disseminated intravascular coagulation (DIC) after Pseudonaja textilis textilis envenomation

Masci P.P., Rowe E.A., Whitaker A.N. and de Jersey J. (1990) Fibrinolysis as a feature of disseminated intravascular coagulation (DIC) after Pseudonaja textilis textilis envenomation. Thrombosis Research, 59 5: 859-870. doi:10.1016/0049-3848(90)90399-W


Author Masci P.P.
Rowe E.A.
Whitaker A.N.
de Jersey J.
Title Fibrinolysis as a feature of disseminated intravascular coagulation (DIC) after Pseudonaja textilis textilis envenomation
Journal name Thrombosis Research   Check publisher's open access policy
ISSN 0049-3848
Publication date 1990-09-01
Sub-type Article (original research)
DOI 10.1016/0049-3848(90)90399-W
Volume 59
Issue 5
Start page 859
End page 870
Total pages 12
Subject 2705 Cardiology and Cardiovascular Medicine
2720 Hematology
Abstract Blood was obtained from four patients envenomated by the Australian common brown snake, Pseudonaja textilis textilis. This elapid snake has one of the most toxic venoms in the world, containing extremely potent neurotoxic and coagulant components. The latter is a potent complete prothrombinase, converting prothrombin to α-thrombin, and comprises more than 30 % of the total venom protein. The four envenomated patients developed a typical consumption coagulopathy. Serial serum and plasma samples from patients were studied by immunoaffinity adsorption, 2-alanine precipitation of fibrinogen and fibrinogen-related products, and 2-dimensional immunoelectrophoresis, and assay for crosslinked fibrin degradation products as D dimer, using the monoclonal antibody, DD-3B6/22. These procedures showed the virtually complete disappearance of fibrinogen, accompanied by the appearance of large quantities of fibrinogen and fibrin degradation products consisting of both crosslinked and noncrossed species. With recovery, a homogeneous high molecular weight fibrinogen was observed. The data suggest that the prothrombin activator of this venom causes the generation of thrombin which subsequently converts fibrinogen to fibrin and stimulates partial crosslinking of both α and γ-chains. The resultant disseminated intravascular coagulation is accompanied by very active secondary fibrinolysis which apparently limits the extent of any microvascular thrombosis but which may contribute to a bleeding tendency.
Keyword disseminated intravascular coagulation
fibrinolysis
prothrombin activator
Pseudonaja textilis textilis
Snake bite
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import
 
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