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Thromb Haemost 2003; 89(02): 355-364
DOI: 10.1055/s-0037-1613453
Wound Healing and Inflammation/Infection
Schattauer GmbH

Blood coagulation and fibrinolytic factors in 105 patients with hemorrhagic syndrome caused by accidental contact with Lonomia obliqua caterpillar in Santa Catarina, Southern Brazil

Marlene Zannin
1   Department of Pathology and Toxicology UFSC Florianópolis SC,
,
Dayse M. Lourenço
2   Hematology Dept. UNIFESP,
,
Guacyara Motta
3   Biochemistry Dept. UNIFESP, São Paulo, SP,
,
Luis R. Dalla Costa
4   Chapecó Blood Center Santa-Catarina,
,
Margaret Grando
5   Center of Toxicology Information, CIT/SC Florianópolis SC,
,
Geni P. Gamborgi
4   Chapecó Blood Center Santa-Catarina,
,
Maria A. Noguti
2   Hematology Dept. UNIFESP,
,
Ana M. Chudzinski-Tavassi
6   Biochemistry and Biophysics Lab., Butantan Institute, São Paulo SP, Brazil
› Author Affiliations
Further Information

Publication History

Received 12 April 2002

Accepted 03 October 2002

Publication Date:
07 December 2017 (online)

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Summary

Haemostatic disorders caused by Lonomia obliqua caterpillars has reached epidemic proportions in southern Brazil. Here we evaluated coagulation and fibrinolysis in 105 patients after accidental contact with Lonomia obliqua caterpillars. Global coagulation tests were prolonged in most cases and patients were divided into 3 groups according to fibrinogen (Fg) level: 0.5 g/l (group A); 0.51–1.5 g/l (group B), >1.5 g/l (group C). There was a significant reduction of factors V, XIII, VIII and prekallikrein in group A, with no change in factors X, II and von Willebrand factor. Thrombin-antithrombin and prothrombin F1+2 were elevated in most patients. Antithrombin and protein S were not changed whereas protein C levels were reduced in group A. Plasminogen and alfa2-antiplasmin levels were significantly reduced in group A and D-Dimer levels were extremely high in all groups, showing that fibrinolysis had been activated, possibly secondary to fibrin production. Levels of t-PA were normal and PAI-1 was mildly elevated in group A. The platelet count remained above 150 × 109 platelets/ml in 97% of cases. In summary, our results suggest that Lonomia obliqua envenoming is characterized by a consumption coagulopathy and secondary fibrinolysis.

Keywords

Lonomia obliqua - envenomation - fibrinolysis - coagulation - DIC
 

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