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Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon contortrix) Envenomation.
Wilderness Environ Med. 2015 Dec; 26(4):488-90.WE

Abstract

Compared with other crotaline envenomations, copperhead envenomations have historically been reported as having less severe hematologic venom effects and rarely hemorrhage. We report a case of clinically significant gastrointestinal bleeding after a copperhead (Agkistrodon contortrix) envenomation. A 52-year-old woman with a history of systemic lupus erythematosus was bitten on her right medial ankle after which hypofibrinogenemia and hematochezia developed. The symptoms resolved after repeated administration of Crotalidae polyvalent immune Fab (ovine) antivenom. She was discharged without further complications 2 days later. Although copperhead envenomations are classically considered less severe than other crotaline envenomations, this case demonstrates the potential of the venom to produce clinically significant hematologic effects.

Authors+Show Affiliations

Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (Dr Kopec); Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (Dr Yen); Division of Emergency Medicine, Duke University Medical Center, Durham, NC (Dr Gerardo). Electronic address: ktkopec@gmail.com.Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (Dr Kopec); Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (Dr Yen); Division of Emergency Medicine, Duke University Medical Center, Durham, NC (Dr Gerardo).Department of Emergency Medicine, Greenville Health System, Greenville, SC (Dr Bitner).Division of Emergency Medicine, Palo Alto VA Medical Center, Palo Alto, CA (Dr Evans).Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (Dr Kopec); Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (Dr Yen); Division of Emergency Medicine, Duke University Medical Center, Durham, NC (Dr Gerardo).

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26432425

Citation

Kopec, Kathryn T., et al. "Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon Contortrix) Envenomation." Wilderness & Environmental Medicine, vol. 26, no. 4, 2015, pp. 488-90.
Kopec KT, Yen M, Bitner M, et al. Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon contortrix) Envenomation. Wilderness Environ Med. 2015;26(4):488-90.
Kopec, K. T., Yen, M., Bitner, M., Evans, C. S., & Gerardo, C. J. (2015). Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon contortrix) Envenomation. Wilderness & Environmental Medicine, 26(4), 488-90. https://doi.org/10.1016/j.wem.2015.07.002
Kopec KT, et al. Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon Contortrix) Envenomation. Wilderness Environ Med. 2015;26(4):488-90. PubMed PMID: 26432425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon contortrix) Envenomation. AU - Kopec,Kathryn T, AU - Yen,May, AU - Bitner,Matthew, AU - Evans,C Scott, AU - Gerardo,Charles J, Y1 - 2015/10/01/ PY - 2015/04/10/received PY - 2015/06/26/revised PY - 2015/07/08/accepted PY - 2015/10/4/entrez PY - 2015/10/4/pubmed PY - 2016/11/5/medline KW - Agkistrodon contortrix KW - copperhead KW - envenomation KW - gastrointestinal bleeding KW - hypofibrinogenemia SP - 488 EP - 90 JF - Wilderness & environmental medicine JO - Wilderness Environ Med VL - 26 IS - 4 N2 - Compared with other crotaline envenomations, copperhead envenomations have historically been reported as having less severe hematologic venom effects and rarely hemorrhage. We report a case of clinically significant gastrointestinal bleeding after a copperhead (Agkistrodon contortrix) envenomation. A 52-year-old woman with a history of systemic lupus erythematosus was bitten on her right medial ankle after which hypofibrinogenemia and hematochezia developed. The symptoms resolved after repeated administration of Crotalidae polyvalent immune Fab (ovine) antivenom. She was discharged without further complications 2 days later. Although copperhead envenomations are classically considered less severe than other crotaline envenomations, this case demonstrates the potential of the venom to produce clinically significant hematologic effects. SN - 1545-1534 UR - https://www.unboundmedicine.com/medline/citation/26432425/Marked_Hypofibrinogenemia_and_Gastrointestinal_Bleeding_After_Copperhead__Agkistrodon_contortrix__Envenomation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1080-6032(15)00242-2 DB - PRIME DP - Unbound Medicine ER -