SERUM LEVELS OF CREATINE KINASE (CK) AND LOCAL TISSUE LESIONS IN THE ENVENOMATION BY Bothrops AND Crotalus SNAKES: CLINICAL, LABORATORIAL AND MAGNETIC RESONANCE IMAGE (MRI) EVALUATION

FONSECA, M.G.(1,2), MATHIAS, M.R.C.(1), YAMASHITA, S.(1), MORCELI, J.(1), BARRAVIERA, B.(1,3)

(1)Hospital das Clínicas, Department of Tropical Diseases and Imaging Diagnosis, Medical School of Botucatu, UNESP, São Paulo, Brazil, (2)Department of Biology, Health Center, FAFIBE-FANORP, State of São Paulo, Brazil, (3)Center for the Study of Venoms and Venomous Animals, CEVAP-UNESP, State of São Paulo, Brazil.

Snake bite envenomation frequently causes alterations in the CK levels associated with local tissue and systemic lesions on skeletal muscles. The present study aimed to evaluate these alterations due to envenomation by Bothrops and Crotalus snakes as well as the evaluation of the local tissue lesions by magnetic resonance images (MRI). For specific treatment, fifteen patients bitten by Bothrops (group Bothrops) and six bitten by Crotalus (group Crotalus) were hospitalized at the Tropical Diseases Section of Hospital das Clínicas of the Medical School of Botucatu. Evaluation of biochemical parameters through the dosage of the CK levels by ultraviolet kinetic method was performed after their admission. Afterwards, they were examined by MRI to screen the damaged member. In the Bothrops group, five patients showed lesions in the subcutaneous tissue, and CK mean value was 260 mUI/l. In six patients, the lesions were in perimuscular areas, CK mean value was 198 mUI/ml. Muscular lesions were found in four patients, CK mean value was 150 mUI/ml. In the Crotalus group, the lesion in subcutaneous tissue were observed in two patients, serum mean level of CK was 1014 mUI/ml. Lesion in perimuscular areas was observed in one patient, CK value of 7620 mUI/ml. Three patients showed lesions in muscular tissue, CK mean level of 4586 mUI/ml. The standard normal value of CK on plasma was 80 mUI/ml. In the Bothrops group, the level of CK was higher in the patients with lesions in subcutaneous tissue. In the patients from the Crotalus group with muscular lesions, the level of CK was higher. The resonance magnetic images showed lesions in subcutaneous tissue, perimuscular and muscular areas in both groups. Although some pacients in both groups presented no local muscular lesions as determined by MRI, the levels of CK were increased.

Support: CAPES

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Mariluce Gonçalves Fonseca, Rua Bartolomeu Bueno Filho, 405, São José Rio Preto, SP, CEP: 15060-230, Brasil, Email: marilucefonseca@hotmail.com