Hemorrhagic syndrome associated with acute kidney injury after an accident caused by Lonomia obliqua
DOI:
https://doi.org/10.33448/rsd-v13i7.46155Keywords:
Lonomia obliqua; Poisoning; Disseminated intravascular coagulation; Acute renal injury.Abstract
This report aims to describe a clinical case of complications arising from an accident involving the venom of the caterpillar of the genus Lonomia oblíqua in a 73-year-old male patient who developed disseminated intravascular coagulopathy and acute dialytic renal injury as consequences of the poisoning. Clinical, epidemiological, and laboratory data were collected from the electronic medical records of the patient at the Institution. The patient underwent intensive treatment, initially with the administration of antilonomic serum, treatment of the coagulation disorder, in addition to renal replacement therapy with hemodialysis, with improvement of the coagulation disorder and maintenance on dialytic therapy. Foundation studies for this work point to the nephrotoxic potential and inducer of alterations in homeostatic patterns resulting from contact with Lonomia venom, as noted in the reported case. The importance of rapid management in the treatment of the victim is emphasized, mainly with the prompt administration of antilonomic serum, in order to avoid worse prognoses.
References
Alvarenga, Z. (1912). A taturana. VII Congresso Brasileiro de Medicina Cirúrgica. Anais da Sociedade de Medicina e Cirurgia; Belo Horizonte, Brazil: 1912. p. 132-5.
Alvarez Flores, M. P., Fritzen, M., Reis, C. V., & Chudzinski-Tavassi, A. M. (2006). Losac, a factor X activator from Lonomia obliqua bristle extract: its role in the pathophysiological mechanisms and cell survival. Biochemical and biophysical research communications, 343(4), 1216–1223. https://doi.org/10.1016/j.bbrc.2006.03.068
Arocha-Piñango, C. L., de Bosch, N. B., Torres, A., Goldstein, C., Nouel, A., Argüello, A., Carvajal, Z., Guerrero, B., Ojeda, A., & Rodriguez, A. (1992). Six new cases of a caterpillar-induced bleeding syndrome. Thrombosis and Haemostasis, 67(4), 402–407.
Arocha-Piñango, C. L., & Guerrero, B. (2003). Síndrome hemorrágico producido por contacto con orugas. Estudios clínicos y experimentales. Revisión [Hemorrhagic syndrome induced by caterpillars. Clinical and experimental studies. Review]. Investigacion clinica, 44(2), 155–163.
Pugliese, M. (2018). Efeitos renais e vasculares da inibição de calicreína em um modelo de lesão renal aguda induzida pelo veneno de Lonomia obliqua.
Berger, M., Santi, L., Beys-da-Silva, W. O., Oliveira, F. M., Caliari, M. V., Yates, J. R., 3rd, Vieira, M. A., & Guimarães, J. A. (2015). Mechanisms of acute kidney injury induced by experimental Lonomia obliqua envenomation. Archives of toxicology, 89(3), 459–483. https://doi.org/10.1007/s00204-014-1264-0
Bohrer, C. B., Junior, R., Fernandes, J., Sordi, D., Guimarães, R., Assreuy, J. A., & Termignoni, J. (2005). Ativação do sistema calicreína-cinina pelas cerdas da lagarta Lonomia obliqua: Envolvimento nas respostas de edema e hipotensão ao envenenamento. Livro de resumos. UFRGS.
Burdmann, E. A., Antunes, I., Saldanha, L. B., & Abdulkader, R. C. (1996). Insuficiencia renal aguda grave inducida por el veneno de las orugas de Lonomia. Nefrología Clínica. 46, 337–339.
Chudzinski-Tavassi, A. M., Zannin, M., D’suze, G., Burguete, C., & Solis, P. (2011). Aspectos clínicos e epidemiológicos do envenenamento por Lonomia obliqua. In Emergências por Animais Ponzonosos nas Américas. Instituto Bioclon; Cidade do México (pp. 303–321).
Da Silva, W. D., Rocha Campos, A. C. M., Gonçalves, L. R. C., Sousa-E-Silva, M. C. C., G. Higashi, H., K. Yamagushi, I., & M.A. Kelen, E. (1996). Short communication. Toxicon: Official Journal of the International Society on Toxinology, 34(9), 1045–1049. https://doi.org/10.1016/0041-0101(96)00052-9
Dizaji, R., Sharafi, A., Pourahmad, J., Abdollahifar, M. A., Vatanpour, H., & Hosseini, M. J. (2019). Induction of two independent immunological cell death signaling following hemoglobinuria -induced acute kidney injury: In vivo study. Toxicon : official journal of the International Society on Toxinology, 163, 23–31. https://doi.org/10.1016/j.toxicon.2019.03.011
Valle dos Anjos, I., & Roberto de Camargo Gonçalves, L. . (2021). Caracterização biológica do extrato de cerdas de Lonomia descimoni (Lepidópteros, Saturniidae) e eficácia da soroterapia no envenenamento experimental. BEPA. Boletim Epidemiológico Paulista, 18(211), 61–64.
Duarte, A. C., Crusius, P. S., Pires, C. A., Schilling, M. A., & Fan, H. W. (1996). Intracerebral haemorrhage after contact with Lonomia caterpillars. Lancet (London, England), 348(9033), 1033. https://doi.org/10.1016/S0140-6736(05)64961-6
Ministério Da, S. (2019). Secretaria de Vigilância em Saúde. Vigilância em saúde no Brasil 2003|2019: da criação da Secretaria de Vigilância em Saúde aos dias atuais. Bol Epidemiol, 50, 1–154.
Gonçalves, L. R., Sousa-e-Silva, M. C., Tomy, S. C., & Sano-Martins, I. S. (2007). Efficacy of serum therapy on the treatment of rats experimentally envenomed by bristle extract of the caterpillar Lonomia obliqua: comparison with epsilon-aminocaproic acid therapy. Toxicon : official journal of the International Society on Toxinology, 50(3), 349–356. https://doi.org/10.1016/j.toxicon.2007.04.004
Kelen, E. M. A., Picarelli, Z. P., & Duarte, A. C. (1995). Hemorrhagic syndrome induced by contact with caterpillars of the genus Lonomia (Saturniidae, hemileucinae). Journal of Toxicology. Toxin Reviews, 14(3), 283–308. https://doi.org/10.3109/15569549509019465
Kowacs, P. A., Cardoso, J., Entres, M., Novak, E. M., & Werneck, L. C. (2006). Fatal intracerebral hemorrhage secondary to Lonomia obliqua caterpillar envenoming: case report. Arquivos de neuro-psiquiatria, 64(4), 1030–1032. https://doi.org/10.1590/s0004-282x2006000600029
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Pineda, D., Amarillo, A., Becerra, J., & Montenegro, G. (2001). Síndrome hemorrágico por contacto con orugas del género Lonomia (Saturniidae) en Casanare, Colombia: informe de dos casos. Biomédica, 21(4), 328–32. https://doi.org/10.7705/biomedica.v21i4.1125
Sano-Martins, I. S., Duarte, A. C., Guerrero, B., Moraes, R. H. P., Barros, E. J. G., & Arocha-Piñango, C. L. (2017). Hemostatic disorders induced by skin contact with Lonomia obliqua (Lepidoptera, Saturniidae) caterpillars. Revista do Instituto de Medicina Tropical de Sao Paulo, 59(0). https://doi.org/10.1590/s1678-9946201759024
Sano-Martins, Ida S., González, C., Anjos, I. V., Díaz, J., & Gonçalves, L. R. C. (2018). Effectiveness of Lonomia antivenom in recovery from the coagulopathy induced by Lonomia orientoandensis and Lonomia casanarensis caterpillars in rats. PLoS Neglected Tropical Diseases, 12(8), e0006721. https://doi.org/10.1371/journal.pntd.0006721
Santos, J., Oliveira, S. S., Alves, E. C., Mendonça-Da-Silva, I., Sachett, J., Tavares, A., Ferreira, L. C., Hw, F., Lacerda, M., & Monteiro, W. M. (2017). Síndrome Hemorrágica Grave Após Lonomia Envenenamento por Lagarta na Amazônia Ocidental Brasileira: Quantos mais casos existem? Ambiente Selvagem. Med, 28, 46–50.
Schmitberger, P., Fernandes, T., Santos, R., de Assis, R., Gomes, A., Siqueira, P., Vitorino, R., de Mendonça, E., de Almeida Oliveira, M. G., & Siqueira-Batista, R. (2013). Probable chronic renal failure caused by Lonomia caterpillar envenomation. The Journal of Venomous Animals and Toxins Including Tropical Diseases, 19(1), 14. https://doi.org/10.1186/1678-9199-19-14
Zannin, M., Lourenço, D. M., Motta, G., Costa, D., Grando, L. R., & Gamborgi, M. (2003). Blood coagulation and fibrinolytic factors in 105 patients with hemorrhagic syndrome caused by acidental contact eith Lonomia obliqua caterpillar in Santa Catarina, Southern Brazil. Thromb Haemost, 89, 355–364.
Garcia, C. M., & Danni-Oliveira, I. M. (2007). Ocorrência de acidentes provocados por Lonomia obliqua Walker, no Estado do Paraná, no período de 1989 a 2001. Revista da Sociedade Brasileira de Medicina Tropical, 40(2), 242–246. https://doi.org/10.1590/s0037-86822007000200021
Siqueira, D. E. D., Luz, J. B. O. da, Lima, J. H. F., Purim, K. S. M., Mendes, L. B., Nascimento, L. V. A. M. do, & Dariva Junior, N. M. (2023). Perfil clínico e epidemiológico dos acidentes por Lepidópteros, do gênero Lonomia, atendidos no CIATox/PR, 2015-2019. Medicina (Ribeirão Preto), 56(1), e-193065. https://doi.org/10.11606/issn.2176-7262.rmrp.2023.193065
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Felipe Gabriel Andrade de Araújo; Beatriz Maria Oliveira da Cunha; Miguel Angelo Albano; Valéria Lima da Cruz; Gilson Fernandes Ruivo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
