Poster 060 - Quantification of venom and antibodies in serum of patients bitten by Bothrops jararaca

Poster 60. Congresso da Sociedade Brasileira de Toxinologia, 8., Symposium of the Pan American Section of the International Society on Toxinology, 8., 2004, Angra dos Reis, Brasil. Abstracts... J. Venom. Anim. Toxins incl.Trop. Dis., 2004, 10, 3, p.419.

Quantification of Venom and Antibodies in Serum of Patients Bitten by Bothrops jararaca

¹Rocha, G.C.; ¹Malta, M.B.; ²França, F.O.S.; ²Málaque, C.M.S.; ²Wen, F.H.; ²Cardoso, J.L.C.; ³Sano-Martins, I.S.; ²Butantan Institute Antivenom Study Group and ¹Barbaro, K.C.

1 Laboratory of Immunopathology; 2 Vital Brazil Hospital; 3 Laboratory of Pathophysiology, Butantan Institute, São Paulo, Brazil.

In Brazil, the genus Bothrops is responsible for about 90% of the snake bites. Envenoming by B. jararaca is usually characterized by bleeding, swelling, pain, ecchymosis and blister at the bite site and systemically coagulation disturbances can occur. The clinical pictures presented by patients in the admission moment at hospital define the severity of envenoming and the amount of anti-bothropic serum to be used as treatment. The aim of this work was to quantify venom and homologous and heterologous antibodies (ELISA) in the serum of patients bitten by B. jararaca treated in Vital Brazil Hospital. From 84 studied patients, 70% of them have the venom detected in serum, range of 1.8 - 111.9 ng/ml (16.7 ± 16.4 ng/ml). Before antivenom administration the mean serum venom level in patients with mild envenoming was lower (13.6 ± 8.7 ng/ml, n= 39) than in the group with moderate envenoming (22.7 ± 24.7 ng/ml, n= 20). No venom was detected in the serum 12 hours (T12) after antivenom therapy. The kinetics of anti-bothropic serum was measured in 66 patients. In T12 the mean anti-bothropic serum concentration was 111.0 ± 47.8 mg/ml, decreasing 59.2% until patients be discharged (2-4 days). Low levels of anti-bothropic serum (2.8 ± 4.9 mg/ml) were detected after 1 month. Homologous anti-venom IgG antibodies were observed in only 13 patients (19.4%) (titers between 800 to 25,600) of 67 samples tested. However IgG anti-bothropic serum antibody were present in 39 (59.1%) from 66 tested patients (titers between 8,000 to 256,000). Our results showed that the determination of serum venom level on admission may contribute to prognostic of envenoming and treatment of patients. Besides, the presence of homologous antibodies against the anti-bothropic serum components can be related with the occurrence of serum sickness.