Unpredicted late-, new-onset thrombocytopenia and hypofibrinogenemia in Fab antivenom-treated rattlesnake envenomation

The use of Fab antivenom (Crotalidae Polyvalent Immune Fab (Ovine) (CroFab); Boston Scientific) against North American Crotalidae envenomation is associated with the development of late- (≥4 days post-envenomation), new-onset of hematological abnormalities. Although attempts have been made to identi...

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Bibliographic Details
Published in:Toxicon (Oxford) 2020-09, Vol.184, p.55-56
Main Authors: Seifert, S.A., Mascarenas, D.N., Fullerton, L., Warrick, B.J., Smolinske, S.C.
Format: Article
Language:English
Subjects:
Antivenom
Envenomation
Fab
Fibrinogen
Platelets
Rattlesnake
Recurrence
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Summary:The use of Fab antivenom (Crotalidae Polyvalent Immune Fab (Ovine) (CroFab); Boston Scientific) against North American Crotalidae envenomation is associated with the development of late- (≥4 days post-envenomation), new-onset of hematological abnormalities. Although attempts have been made to identify predictive indicators during the acute phase of an envenomation, of patients who are not at-risk of late-, new-onset of hematological abnormalities, there has been at least one prior report of a patient who developed thrombocytopenia that was unpredicted by current indicators. We add three cases of unpredicted, late-, new-onset of hematological abnormalities in patients with Fab-treated rattlesnake bite. •Fab antivenom is associated with late-, new-onset hematological abnormalities.•Predictors for absence of post-discharge hematologic risk have not been validated.•Exceptions to predictors have been found.•We add three additional cases of unpredicted, late hematologic abnormalities.•All Fab-treated patients should be followed with lab for at least one week.
ISSN:0041-0101
1879-3150
DOI:10.1016/j.toxicon.2020.05.026