Plasma Thrombin Assay using a Chromogenic Substrate in Disseminated Intravascular Coagulation due to Snake Bite Envenomation

Summary

Using the chromogenic substrate, Tos-Gly-Pro-Arg-pNA-HCL (Chromozym TH, Boehringer Mannheim) plasma thrombin was estimated in six cases of envenomation by Australian elapid snakes. All patients manifested findings chracteristic of defibrination due to envenomation by these snakes. Fibrin-fibrinogen degradation products were grossly elevated, as was plasma thrombin in all cases.

Following treatment with antivenene, all abnormal coagulation parameters returned rapidly towards normal by 24 hours and plasma thrombin disappeared.

• References

• 1 Austen DE G, Rhymes IL. 1975. Factor VIII Assay. In: A Laboratory Manual of Blood Coagulation. Blackwell Scientific Publications; Oxford: 50
• 2 Burmester HB C, Aulton K, Horsfield GI. 1970; Evaluation of a Rapid Method for the Determination of Plasma Fibrinogen. Journal of Clinical Pathology 23: 43
• 3 Dacie JV, Lewis SM. 1975. Practical Haematology. 5th. Ed. Churchill Livingstone; London & Edinburgh: 331
• 4 Davey MG. Luescher 1967; Actions of Thrombin Other Coagulant and Proteolytic Enzymes on Blood Platelets. Nature 216: 857
• 5 Davis RE, Green R. 1967; Automatic Platelet Counting with the Coulter Particle Counters. Journal of Clinical Pathology 20: 777
• 6 Gaffney PJ, Lord K, Brasher M, Kirkwood TB C. 1977; Problems in the Assay of Thrombin Using Synthetic Peptides as Substrates. Thrombosis Research 10: 549
• 7 Garnet JR. editor 1968; Venomous Australian Animals Dangerous to Man. C. S. L., Melbourne 48
• 8 Hardistry RM, Ingram GI C. 1965. Bleeding Disorders. Blackwell; Oxford: 285
• 9 Herrmann RP, Davey MG, Skidmore PH. 1972; The Coagulation Defect After Envenomation by the Bite of the Dugite (Demansia nuchalis affinis). Medical Journal of Australia 2: 183