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1.
Rev. Col. Méd. Cir. Guatem ; 156(1): 47-50, 2017 jul. ilus
Artigo em Espanhol | LILACS | ID: biblio-982135

RESUMO

La mordedura por araña del género Loxosceles produce dermonecrosis en el sitio de la lesión y complicaciones sistémicas secundarias a reacciones enzimáticas de su veneno, lo que aumenta la tasa de mortalidad. El objetivo es reportar cuatro casos de loxoscelismo atendidos en el hospital General San Juan de Dios, donde los pacientes tuvieron una evolución satisfactoria a pesar de la inexistencia del antiveneno como manejo ideal de la toxicidad (AU)


Assuntos
Humanos , Feminino , Picaduras de Aranhas/tratamento farmacológico , Venenos de Aranha/efeitos adversos , Aranha Marrom Reclusa/patogenicidade , Hemólise , Guatemala
2.
PLoS One ; 12(4): e0174941, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28422977

RESUMO

OBJECTIVE: Systemic loxoscelism is a rare illness resulting from the bite of the recluse spider and, in its most severe form, can lead to widespread hemolysis, coagulopathy, and death. We aim to describe the clinical features and outcomes of the largest known cohort of individuals with moderate to severe loxoscelism. METHODS: We performed a retrospective, cross sectional study from January 1, 1995, to December 31, 2015, at a tertiary-care academic medical center, to determine individuals with clinical records consistent with moderate to severe loxoscelism. Age-, sex-, and race-matched controls were compared. Demographics, clinical characteristics, laboratory measures, and outcomes of individuals with loxoscelism are described. Case and control groups were compared with descriptive statistics and phenome-wide association study (PheWAS). RESULTS: During the time period, 57 individuals were identified as having moderate to severe loxoscelism. Of these, only 33% had an antecedent spider bite documented. Median age of individuals diagnosed with moderate to severe loxoscelism was 14 years old (IQR 9.0-24.0 years). PheWAS confirmed associations of systemic loxoscelism with 29 other phenotypes, e.g., rash, hemolytic anemia, and sepsis. Hemoglobin level dropped an average of 3.1 g/dL over an average of 2.0 days (IQR 2.0-6.0). Lactate dehydrogenase and total bilirubin levels were on average over two times their upper limit of normal values. Eighteen individuals of 32 tested had a positive direct antiglobulin (Coombs') test. Mortality was 3.5% (2/57 individuals). CONCLUSION: Systemic loxoscelism is a rare but devastating process with only a minority of patients recalling the toxic exposure; hemolysis reaches a peak at 2 days after admission, with some cases taking more than a week before recovery. In endemic areas, suspicion for systemic loxoscelism should be high in individuals, especially children and younger adults, presenting with a cutaneous ulcer and hemolysis or coagulopathy, even in the absence of a bite exposure history.


Assuntos
Aranha Marrom Reclusa/patogenicidade , Coagulação Intravascular Disseminada/diagnóstico , Picaduras de Aranhas/diagnóstico , Venenos de Aranha/toxicidade , Adolescente , Animais , Bilirrubina/sangue , Estudos de Casos e Controles , Criança , Estudos Transversais , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/mortalidade , Coagulação Intravascular Disseminada/fisiopatologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Hemoglobinas/metabolismo , Hemólise/efeitos dos fármacos , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Fenótipo , Estudos Retrospectivos , Picaduras de Aranhas/sangue , Picaduras de Aranhas/mortalidade , Picaduras de Aranhas/fisiopatologia , Análise de Sobrevida , Adulto Jovem
3.
J Cell Biochem ; 118(4): 726-738, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27563734

RESUMO

Loxoscelism refers to the clinical symptoms that develop after brown spider bites. Brown spider venoms contain several phospholipase-D isoforms, which are the main toxins responsible for both the cutaneous and systemic effects of loxoscelism. Understanding of the phospholipase-D catalytic mechanism is crucial for the development of specific treatment that could reverse the toxic effects caused by the spider bite. Based on enzymatic, biological, structural, and thermodynamic tests, we show some features suitable for designing drugs against loxoscelism. Firstly, through molecular docking and molecular dynamics predictions, we found three different molecules (Suramin, Vu0155056, and Vu0359595) that were able to bind the enzyme's catalytic site and interact with catalytically important residues (His12 or His47) and with the Mg2+ co-factor. The binding promoted a decrease in the recombinant brown spider venom phospholipase-D (LiRecDT1) enzymatic activity. Furthermore, the presence of the inhibitors reduced the hemolytic, dermonecrotic, and inflammatory activities of the venom toxin in biological assays. Altogether, these results indicate the mode of action of three different LiRecDT1 inhibitors, which were able to prevent the venom toxic effects. This strengthen the idea of the importance of designing a specific drug to treat the serious clinical symptoms caused by the brown spider bite, a public health problem in several parts of the world, and until now without specific treatment. J. Cell. Biochem. 118: 726-738, 2017. © 2016 Wiley Periodicals, Inc.


Assuntos
Proteínas de Artrópodes/antagonistas & inibidores , Aranha Marrom Reclusa/enzimologia , Desenho de Fármacos , Fosfolipase D/antagonistas & inibidores , Venenos de Aranha/antagonistas & inibidores , Animais , Proteínas de Artrópodes/química , Proteínas de Artrópodes/genética , Benzimidazóis/farmacologia , Aranha Marrom Reclusa/genética , Aranha Marrom Reclusa/patogenicidade , Avaliação Pré-Clínica de Medicamentos , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Hemólise/efeitos dos fármacos , Humanos , Cinética , Ligantes , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Necrose , Fosfolipase D/química , Fosfolipase D/genética , Diester Fosfórico Hidrolases/química , Diester Fosfórico Hidrolases/genética , Piperidinas/farmacologia , Coelhos , Proteínas Recombinantes/genética , Pele/efeitos dos fármacos , Pele/patologia , Picaduras de Aranhas/tratamento farmacológico , Picaduras de Aranhas/enzimologia , Venenos de Aranha/química , Venenos de Aranha/genética , Suramina/farmacologia
5.
Rev. AMRIGS ; 59(2): 134-139, abr.-jun. 2015. ilus
Artigo em Português | LILACS | ID: biblio-834139

RESUMO

Os acidentes com aranhas do gênero Loxosceles podem apresentar variadas evoluções clínicas, dificultando a realização do diagnóstico e a escolha correta de uma medida terapêutica. Este artigo de revisão tem como objetivo abordar os mais importantes mecanismos de evolução, principais desfechos e os tratamentos de escolha para o acidente loxoscélico (AU)


Accidents with Loxosceles genus spiders may have different clinical outcomes, hindering the diagnosis and the correct choice of a therapeutic measure. This review article aims to address the main mechanisms of evolution, main outcomes and treatments of choice for loxoscelic accident (AU)


Assuntos
Humanos , Animais , Aranha Marrom Reclusa/patogenicidade , Picaduras de Aranhas/diagnóstico , Picaduras de Aranhas/terapia , Aranha Marrom Reclusa/enzimologia , Picaduras de Aranhas/complicações , Picaduras de Aranhas/epidemiologia , Picaduras de Aranhas/patologia , Picaduras de Aranhas/fisiopatologia , Picaduras de Aranhas/prevenção & controle
6.
Semin Cutan Med Surg ; 33(3): 123-7, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25577851

RESUMO

Spider bites represent an unusual and potentially over-represented clinical diagnosis. Despite a common fear of spiders, known as arachnophobia, current knowledge suggests that only a small number of families within the order Araneae are medically relevant. Moreover, most cutaneous spider reactions, including both evenomations and physical trauma, produce mild, local symptoms which may be managed with supportive care alone. The differential diagnosis for spider bites may be broad, especially if the offending arachnid is not seen or found. We describe a series of spiders relevant to the dermatologist in the United States.


Assuntos
Picaduras de Aranhas/diagnóstico , Aranhas/anatomia & histologia , Animais , Aranha Marrom Reclusa/anatomia & histologia , Aranha Marrom Reclusa/classificação , Aranha Marrom Reclusa/patogenicidade , Diagnóstico Diferencial , Humanos , Necrose , Pele/patologia , Picaduras de Aranhas/complicações , Picaduras de Aranhas/terapia , Aranhas/classificação , Aranhas/patogenicidade
7.
Cir. plást. ibero-latinoam ; 29(2): 167-171, abr.-jun. 2003. ilus
Artigo em Espanhol | IBECS | ID: ibc-135571

RESUMO

Las picaduras de araña sin trascendencia clínica son frecuentes, manifestándose en forma de eritema, edema local y dolor. Generah11ente los pacientes no identifican a la araña en el momento de la lesión. El término loxoscelismo hace referencia a las lesiones locales dedermonecrosis y las manifestaciones generales (hemólisis, fallo renal agudo, coagulación .intravascular diseminada) producidas por la picadura de un tipo de araña doméstica, la Loxosceles reclusa. Se presentan dos casos clínicos de pacientes que sufrieron una picadura de araña común, desarrollando posteriormente necrosis cutánea de rápida evolución que requirió tratamiento quirúrgico. Analizamos la fisiopatología y los mecanismos implicados en este tipo de lesiones y efectuamos una revisión y puesta al día del manejo terapéutico de las mismas (AU)


Most spider bites involving humans cause minimal medica! problems and result in erythema, local edema and pain. Patients infrcquently present with a positive identification after potential envenomation. Loxoscelism is used to describe dermonecrosis lesions and general reactions (haemolysis, acure renal failure, disseminated intravascular coagulation) induced by domestic spiders bite (Loxosceles reclusa). Two cases of spiders bite that develop a fast dermonecrosis and need surgical treatment are reported. We analized the fisiopathology and mecanism of these kind of Iession and present a treatment review (AU)


Assuntos
Humanos , Feminino , Pré-Escolar , Adulto , Picaduras de Aranhas/complicações , Picaduras de Aranhas/terapia , Necrose/complicações , Necrose/cirurgia , Picaduras de Aranhas/fisiopatologia , Picaduras de Aranhas/cirurgia , Procedimentos Cirúrgicos Dermatológicos/métodos , Procedimentos Cirúrgicos Dermatológicos/tendências , Procedimentos Cirúrgicos Dermatológicos , Aranha Marrom Reclusa/patogenicidade , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/cirurgia , Retalhos Cirúrgicos
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