MYONECROSIS, MYOGLOBINURIA AND ACUTE RENAL-FAILURE INDUCED BY SOUTH-AMERICAN RATTLESNAKE (CROTALUS-DURISSUS-TERRIFICUS) ENVENOMATION IN BRAZIL
MYONECROSIS, MYOGLOBINURIA AND ACUTE RENAL-FAILURE INDUCED BY SOUTH-AMERICAN RATTLESNAKE (CROTALUS-DURISSUS-TERRIFICUS) ENVENOMATION IN BRAZIL
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DOI：
10.1016/0041-0101(85)90367-8
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发表时间：
1985-01-01
期刊：
影响因子：
2.8
通讯作者：
LAURE, CJ
中科院分区：
文献类型：
--
作者：
AZEVEDOMARQUES, MM;CUPO, P;LAURE, CJ
已知巴西响尾蛇Crotalus durissus terrificus的毒液具有溶血性和神经毒性生理病理学活性，可导致急性肾衰竭伴血红蛋白尿和/或高铁血红蛋白尿。据我们所知，还没有关于这种响尾蛇毒液引起横纹肌溶解症的报道。在本文中，我们表明，毒液的基因响尾蛇巴西蛇可以诱导全身性肌坏死。临床，实验室和解剖病理学数据的两个病人提到的里贝劳普雷托，圣保罗大学，24小时响尾蛇咬伤后，医学院的大学医院。在这两种情况下，检测到肌酸磷酸激酶、乳酸脱氢酶和谷草转氨酶的血清水平过度升高，以及提示急性高分解代谢性肾衰竭的数据。对这些患者的血清和尿液进行免疫电泳，针对特异性抗肌红蛋白血清（Behringwerke），证明肌红蛋白血症和肌红蛋白尿，确认肌肉组织损伤。从一个病人的小腿对侧的咬伤的小腿肌肉的电子显微镜检查显示肌坏死灶。
The venom of the Brazilian rattlesnake Crotalus durissus terrificus is known to have hemolytic and neurotoxic physiopathological activities which may cause acute renal failure with hemoglobinuria and/or methemoglobinuria. As far as we know, no report has been published on the ability of the venom of this rattlesnake species to cause rhabdomyolysis. In the present paper we demonstrate that the venom of Brazilian snakes of the genes Crotalus can induce systemic myonecrosis. Clinical, laboratory and anatomo-pathological data for two patients referred to the University Hospital of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, 24 h after a rattlesnake bite, are presented. In both cases, exaggerated elevation of serum levels of the enzymes creatine phosphokinase, lactate dehydrogenase and glutamic-oxaloacetic transaminase were detected, as well as data suggesting acute hypercatabolic renal failure. Immunoelectrophoresis of the serum and urine of these patients, carried out against specific anti-myoglobin serum (Behringwerke), demonstrated myoglobinemia and myoglobinuria, confirming injury to muscle tissue. Electron microscopy of a calf muscle taken from the leg contralateral to the bite from one patient revealed foci of myonecrosis.