Low accuracy of microscopic hematuria in detecting coagulopathy from Bothrops pit viper bites, Brazilian Amazon.
Clin Toxicol (Phila)
; 57(9): 816-818, 2019 Sep.
Article
in En
| MEDLINE
| ID: mdl-30704302
ABSTRACT
Introduction:
The common lancehead snakes (Bothrops atrox) are responsible for up to 90% of snakebites in the Amazon, especially in remote areas. The prevalence of microhematuria is similar to that of coagulopathy in B. atrox envenomation in the Amazon. Thus, this study aimed to assess the reliability of microhematuria as an inexpensive and simple alternative to detect snake-induced consumption coagulopathy.Methods:
We analyzed samples from patients with confirmed B. atrox envenomation in terms of plasma fibrinogen and microhematuria (>3 red blood cells per high power field) in order to access the reliability of microhematuria to detect snakebite-induced coagulopathy, within 12 hours from admission.Results:
A total of 186 patients were recruited. From the total, 85.5% of patients had hypofibrinogenemia and only about 50% (n = 94) had a microscopic examination of urine within 12 hours where microhematuria was present in 39 (41.5%). Diagnostic performance showed 38.6% sensitivity and 36.4% specificity (cutpoint 200 mg/dL). No clear association was seen between microhematuria and hypofibrinogenemia (r -0.10; p .34).Conclusion:
In this study, microhematuria presented poor diagnostic performance to detect coagulopathy. Further studies are necessary to screen inexpensive and simple alternative diagnostic tools.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Snake Bites
/
Blood Coagulation Disorders
/
Bothrops
/
Hematuria
Type of study:
Diagnostic_studies
/
Risk_factors_studies
Limits:
Animals
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Clin Toxicol (Phila)
Journal subject:
TOXICOLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Brazil