Fibrinolysis as a feature of disseminated intravascular coagulation (DIC) after Pseudonaja textilis textilis envenomation

摘要: Blood was obtained from four patients envenomated by the Australian common brown snake, Pseudonaja textilis textilis. This elapid snake has one of most toxic venoms in world, containing extremely potent neurotoxic and coagulant components. The latter is a complete prothrombinase, converting prothrombin to α-thrombin, comprises more than 30 % total venom protein. developed typical consumption coagulopathy. Serial serum plasma samples were studied immunoaffinity adsorption, 2-alanine precipitation fibrinogen fibrinogen-related products, 2-dimensional immunoelectrophoresis, assay for crosslinked fibrin degradation products as D dimer, using monoclonal antibody, DD-3B6/22. These procedures showed virtually disappearance fibrinogen, accompanied appearance large quantities consisting both noncrossed species. With recovery, homogeneous high molecular weight observed. data suggest that activator this causes generation thrombin which subsequently converts stimulates partial crosslinking α γ-chains. resultant disseminated intravascular coagulation very active secondary fibrinolysis apparently limits extent any microvascular thrombosis but may contribute bleeding tendency.