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Hyperglycemia is a risk factor for high-grade envenomations after European viper bites (Vipera spp.) in children.
Clin Toxicol (Phila). 2016; 54(1):34-9.CT

Abstract

CONTEXT

Hyperglycemia has been described in severe scorpion envenomation, we wanted to analyze if it was applicable to viper bites in children.

AIM

To describe clinical, biological, and therapeutic characteristics of 83 children bitten by European viper (Vipera spp.) and to confirm that hyperglycemia is a risk factor for high-grade envenomation.

MATERIAL AND METHODS

A retrospective study was conducted between 2001 and 2014 in the pediatric emergency department of a tertiary level children's hospital. Collected data were: age and sex of children; day and time of admission; day, time and circumstances of the accident; snake identification; bite location; envenomation severity; presence of fang marks; prehospital care; laboratory abnormalities, use of specific immunotherapy, associated treatments; length of stay; hospital course.

RESULTS

Eighty-three children were included (62 boys, 21 girls). The mean age was 7.4 ± 3.9 years. Bites were most often located on the lower extremities (66%). The classification of envenomation was: 83% low grade (absent or minor envenomation) and 17% high grade (moderate to severe envenomation). All high-grade envenomations received specific immunotherapy (Viperfav(TM), (Aventis Pasteur, MSD, Lyon, France). Being bitten on an upper extremity (odds ratio [OR] 51.1 95% class interval [CI] [6.1-424], p < 0.0001), during the afternoon (OR 13.4 95% CI [1.7-107.9], p = 0.015), feeling violent pain (OR 4.2 95% CI [1.1-16.5], p = 0.023), and high initial plasma glucose level (6.5 ± 1.7 mmol/L versus 5.0 ± 0.9 mmol/L, p = 0.027) were associated with a significant risk of high-grade envenomation.

CONCLUSION

We have confirmed a potential link between initial hyperglycemia and the risk of progression to high-grade envenomation as well as its association with other published predictive factors.

Authors+Show Affiliations

a Pediatric Emergency Department , Children Hospital , Toulouse , France ;a Pediatric Emergency Department , Children Hospital , Toulouse , France ;b Regional Poison Centre, CHU Purpan , Toulouse , France.b Regional Poison Centre, CHU Purpan , Toulouse , France.a Pediatric Emergency Department , Children Hospital , Toulouse , France ;

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26582080

Citation

Claudet, I, et al. "Hyperglycemia Is a Risk Factor for High-grade Envenomations After European Viper Bites (Vipera Spp.) in Children." Clinical Toxicology (Philadelphia, Pa.), vol. 54, no. 1, 2016, pp. 34-9.
Claudet I, Grouteau E, Cordier L, et al. Hyperglycemia is a risk factor for high-grade envenomations after European viper bites (Vipera spp.) in children. Clin Toxicol (Phila). 2016;54(1):34-9.
Claudet, I., Grouteau, E., Cordier, L., Franchitto, N., & Bréhin, C. (2016). Hyperglycemia is a risk factor for high-grade envenomations after European viper bites (Vipera spp.) in children. Clinical Toxicology (Philadelphia, Pa.), 54(1), 34-9. https://doi.org/10.3109/15563650.2015.1113542
Claudet I, et al. Hyperglycemia Is a Risk Factor for High-grade Envenomations After European Viper Bites (Vipera Spp.) in Children. Clin Toxicol (Phila). 2016;54(1):34-9. PubMed PMID: 26582080.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperglycemia is a risk factor for high-grade envenomations after European viper bites (Vipera spp.) in children. AU - Claudet,I, AU - Grouteau,E, AU - Cordier,L, AU - Franchitto,N, AU - Bréhin,C, Y1 - 2015/11/18/ PY - 2015/11/20/entrez PY - 2015/11/20/pubmed PY - 2016/4/12/medline KW - Viper bite KW - envenomation KW - high grade KW - hyperglycemia KW - pediatric SP - 34 EP - 9 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 54 IS - 1 N2 - CONTEXT: Hyperglycemia has been described in severe scorpion envenomation, we wanted to analyze if it was applicable to viper bites in children. AIM: To describe clinical, biological, and therapeutic characteristics of 83 children bitten by European viper (Vipera spp.) and to confirm that hyperglycemia is a risk factor for high-grade envenomation. MATERIAL AND METHODS: A retrospective study was conducted between 2001 and 2014 in the pediatric emergency department of a tertiary level children's hospital. Collected data were: age and sex of children; day and time of admission; day, time and circumstances of the accident; snake identification; bite location; envenomation severity; presence of fang marks; prehospital care; laboratory abnormalities, use of specific immunotherapy, associated treatments; length of stay; hospital course. RESULTS: Eighty-three children were included (62 boys, 21 girls). The mean age was 7.4 ± 3.9 years. Bites were most often located on the lower extremities (66%). The classification of envenomation was: 83% low grade (absent or minor envenomation) and 17% high grade (moderate to severe envenomation). All high-grade envenomations received specific immunotherapy (Viperfav(TM), (Aventis Pasteur, MSD, Lyon, France). Being bitten on an upper extremity (odds ratio [OR] 51.1 95% class interval [CI] [6.1-424], p < 0.0001), during the afternoon (OR 13.4 95% CI [1.7-107.9], p = 0.015), feeling violent pain (OR 4.2 95% CI [1.1-16.5], p = 0.023), and high initial plasma glucose level (6.5 ± 1.7 mmol/L versus 5.0 ± 0.9 mmol/L, p = 0.027) were associated with a significant risk of high-grade envenomation. CONCLUSION: We have confirmed a potential link between initial hyperglycemia and the risk of progression to high-grade envenomation as well as its association with other published predictive factors. SN - 1556-9519 UR - https://www.unboundmedicine.com/medline/citation/26582080/Hyperglycemia_is_a_risk_factor_for_high_grade_envenomations_after_European_viper_bites__Vipera_spp___in_children_ L2 - https://www.tandfonline.com/doi/full/10.3109/15563650.2015.1113542 DB - PRIME DP - Unbound Medicine ER -