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An examination of the haemostatic changes induced in humans bitten by the Papuan Taipan (Oxyuranus scutellatus canni) and applications of the venom for use in the haemostasis diagnostic laboratory

Owens, Dale Lesley; (1996) An examination of the haemostatic changes induced in humans bitten by the Papuan Taipan (Oxyuranus scutellatus canni) and applications of the venom for use in the haemostasis diagnostic laboratory. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

An examination of the haemostatic changes induced in 84 patients bitten by the Papuan taipan (Oxyuranus scutellatus canni), 13 patients bitten by the death adder (Acanthophis sp) and 4 patients bitten by the Papuan Black snake (Pseudechis papuanus) were studied. A wide range of haemostatic analytes were measured, comparing envenomed patients to 59 healthy Papuan controls. 68 patients bitten by the taipan suffered a consumptive coagulopathy, caused by the presence of a prothrombin activator in the venom. All 68 patients were severely defibrinated (<0.5g/l), and had prolonged screening tests (median PT>120, APTT>180). A range of factor levels were reduced, including factors II, V, VIII, IX, XI and XII, the most markedly reduced were factors V and VIII (median 5.0u/dl and 7.0u/dl respectively). Of the physiological inhibitors measured. Protein C was consumed to a median level of 44u/dl. Plasminogen and ?2-antiplasmin were consumed to median levels of 53.5 and 41.0u/dl respectively, which in addition to markedly elevated FDPs, indicated active fibrin(ogen)lysis. As expected from a prothrombin activating component, markers of thrombin generation (TAT and F1+2) were elevated. Recovery of haemostatic proteins were measured in eight patients post antivenom treatment at two hourly intervals. Most factors returned to within the normal range by 48 hours. In-vitro studies were performed with crude venom from the Papuan taipan to further elucidate the mechanism of the coagulopathy. There was no evidence found of any direct activity of the venom on the fibrinolytic system, platelets or the coagulation system, other then secondary activation to thrombin generation. A confirmatory test for the detection of lupus anticoagulants was established using the unique properties of the procoagulant component.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: An examination of the haemostatic changes induced in humans bitten by the Papuan Taipan (Oxyuranus scutellatus canni) and applications of the venom for use in the haemostasis diagnostic laboratory
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Health and environmental sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10104719
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