Subject(s)
Abdominal Injuries/diagnostic imaging , Ascites/diagnostic imaging , Edema/diagnostic imaging , Hereditary Angioedema Types I and II/diagnostic imaging , Intestinal Diseases/diagnostic imaging , Wounds, Nonpenetrating/diagnosis , Child , Diagnosis, Differential , Female , Humans , Ultrasonography/methods , Wounds, Nonpenetrating/diagnostic imagingSubject(s)
Aorta, Thoracic/abnormalities , Aortic Arch Syndromes/complications , Aortic Arch Syndromes/diagnostic imaging , Bronchitis/diagnostic imaging , Bronchitis/etiology , Tracheal Stenosis/diagnostic imaging , Tracheal Stenosis/etiology , Aorta, Thoracic/diagnostic imaging , Child , Diagnosis, Differential , Humans , Male , Radiography, Thoracic/methods , StudentsABSTRACT
Adder bites are occasionally occurring envenoming emergencies. More than ten percent of the clinical courses are severe and even life-threatening. Children and elderly patients are over-represented in this group. Common symptoms comprise local edema, abdominal pain and vomiting, arterial hypotension and neurological disorders. First steps in the management are immobilization of the affected extremity, reassurance of the patient and application of analgetics. Anaphylaxis may occur and requires status adapted treatment. Persistent circulatory shock, protracted gastrointestinal or severe neurological symptoms, as well as rapidly progressing edema and airway obstruction are indications for antivenom treatment. Administration of antivenom results in prompt clinical improvement and in a significantly shorter hospital stay.
Subject(s)
Antivenins/therapeutic use , Snake Bites , Viper Venoms , Viperidae , Age Distribution , Aged , Animals , Child , Germany/epidemiology , Humans , Snake Bites/diagnosis , Snake Bites/epidemiology , Snake Bites/physiopathology , Snake Bites/therapy , Viper Venoms/immunology , Viper Venoms/poisoningABSTRACT
BACKGROUND: In patients with Henoch-Schoenlein purpura (HSP), particularly with severe gastrointestinal symptoms, an associated decrease of plasma factor XIII has been observed. PATIENT: The authors report a case of HSP in a boy and describe the development of factor XIII activities throughout the course of the disease. Every relapse of severe gastrointestinal manifestation was associated with a decrease of factor XIII. No improvement was seen after treatment with prednisone. The symptoms resolved each time factor XIII concentrate was administered. With the return of factor XIII to normal values eight weeks after admission abdominal symptoms ceased. CONCLUSION: The documented course supports the hypothesis that factor XIII activity correlates well with the severity of abdominal symptoms. Measuring factor XIII activity helps to identify those patients with severe gastrointestinal manifestation who may benefit from substitution therapy.
