A randomized blinded clinical trial of two antivenoms, prepared by caprylic acid or ammonium sulphate fractionation of IgG, in Bothrops and Porthidium snake bites in Colombia: correlation between safety and biochemical characteristics of antivenoms

 

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Detalles Bibliográficos
Autores: Otero Patiño, Rafael, Gutiérrez, José María, Rojas Céspedes, Gustavo, Núñez Rangel, Vitelbina, Díaz, Abel, Miranda, E., Uribe, A. F., Silva, Juan F., Ospina, J. G., Medina, Y., Toro, María Fabiola, García, Martha E., León Montero, Guillermo, García, M., Lizano González, Sergio, De La Torre, J., Márquez, J., Mena, Y., González, N., Arenas, L. C., Puzón, A., Blanco, N., Sierra, A., Espinal, M. E., Arboleda, Margarita, Jiménez, J. C., Ramírez, P., Díaz, M., Guzmán, M. C., Barros, J., Henao, S., Ramírez, A., Macea, U., Lozano, R.
Formato: artículo original
Fecha de Publicación:1999
Descripción:A randomized blinded clinical trial was performed in 53 patients bitten by Bothrops sp. and Porthidium sp. in Antioquia and Chocó, Colombia, in order to compare the efficacy and safety of two antivenoms made of whole IgG obtained by either ammonium sulphate (monovalent anti-B. atrox) or caprylic acid (polyvalent) fractionation. Additionally, antivenoms were compared by electrophoretic and chromatographic analyses and anticomplementary activity in vitro. With a protocol of 2, 4 and 6 antivenom vials for the treatment of mild, moderate and severe envenomings, respectively, both antivenoms were equally efficient to neutralize the most relevant signs of envenoming and to clear serum venom levels in patients from the first hour and later on. Three patients with severe envenoming and initially treated with less than six vials on admission had persistent or recurrent venom antigenemia within 12-48 h. Monovalent antivenom fractionated by ammonium sulphate precipitation had higher amounts of protein aggregates and nonimmunoglobulin proteins than polyvalent antivenom fractionated by caprylic acid precipitation. Both antivenoms presented anticomplementary activity in vitro, being higher in the monovalent product. In agreement, monovalent antivenom induced a significantly higher incidence of early antivenom reactions (52%) than polyvalent antivenom (25%).
País:Kérwá
Institución:Universidad de Costa Rica
Repositorio:Kérwá
OAI Identifier:oai:kerwa.ucr.ac.cr:10669/29452
Acceso en línea:http://www.sciencedirect.com/science/article/pii/S0041010198002207
https://hdl.handle.net/10669/29452
Palabra clave:Adolescent
Adult
Aged
Ammonium Sulfate
Animals
Antivenins
Bothrops
Caprylates
Chemical Fractionation
Child
Colombia
Crotalid Venoms
Double-Blind Method
Horses
Humans
Immunoglobulin G
Infant
Middle Aged
Safety
Snake Bites
Treatment Outcome
Snake venom

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