Prediction, prevention, and mechanism of early (anaphylactic) antivenom reactions in victims of snake bites

Victims of snake bites are often subjected to cutaneous or conjunctival hypersensitivity testing before being given antivenom. None of 12 early (anaphylactic) reactions was predicted by these tests in 25 Nigerian and Thai patients. The incidence and severity of early reactions was the same whether a...

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Bibliographic Details
Published in:BMJ 1986-01, Vol.292 (6512), p.17-20
Main Authors: Malasit, P, Warrell, D A, Chanthavanich, P, Viravan, C, Mongkolsapaya, J, Singhthong, B, Supich, C
Format: Article
Language:English
Subjects:
Anaphylaxis
Anaphylaxis - etiology
Anaphylaxis - prevention & control
Antigen antibody complex
Antivenins
Antivenins - administration & dosage
Antivenins - adverse effects
Antivenins - immunology
Complement Activation
Horses
Humans
Infusions, Parenteral
Injections, Intravenous
Intravenous injections
Nonprofit organizations
Snake bites
Snake Bites - immunology
Snake Bites - therapy
Snakes
Venoms
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Summary:Victims of snake bites are often subjected to cutaneous or conjunctival hypersensitivity testing before being given antivenom. None of 12 early (anaphylactic) reactions was predicted by these tests in 25 Nigerian and Thai patients. The incidence and severity of early reactions was the same whether antivenom was given by intravenous injection over 10 minutes or diluted and given as an intravenous infusion over 30 minutes. Although antivenom activated complement in vitro, there was no evidence of complement activation or formation of immune complexes in patients bitten by snakes who were treated with antivenom, whether or not they developed early reactions. Higher doses of antivenom might induce the complement activation and formation of immune complexes (aggregates) that have been observed during the clinically more severe reactions associated with homologous immunoglobulin treatment.
ISSN:0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.292.6512.17