Hemotoxicity severity

SAFETY PROFILE Suspected carcinogen with experimental carcinogenic data. A human poison by inhalation. Human systemic effects by inhalation anorexia, nausea or vomiting. Corrosive to skin can produce severe burns. Human mutation data reported. A powerful fumigant gas that is one of the most toxic of the common organic halides. It is hemotoxic and narcotic with delayed action. The effects are cumulative and damaging to nervous system, kidneys, and lung. Central nervous system effects include blurred vision, mental confusion, numbness, tremors, and speech defects. 

Isolated anemia is not a common feature of the hemotoxic effects of interferon alfa, and pure red cell aplasia has been reported in two patients with chronic leukemia for several months (217,218). Both patients improved progressively after replacement of interferon alfa by hydroxyurea. However, one required erythrocyte transfusions for 14 months. 

Snake venoms are complex mixtures of several different components or fractions that can vary considerably within Crotalinae members. A complete review of venom components is beyond the scope of this review. Depending on the content of the venom, multiple organ systems may be affected. Historically, Crotalinae venom was classified as neurotoxic, hemotoxic, cardiotoxic, or myotoxic, depending on the species of snake involved in the envenomation. This oversimplifies the complex nature of Crotalinae venom. Clinically, a patient may develop such multisystem disorders as platelet destruction, internal bleeding, hypotension, paresthesias, and rhabdomyolysis. 

Clinical manifestation. It includes several syndromes a) pulmotoxic and irritative syndrome - expressed by catarrhal changes on the contact mucosa and respiratory tract, toxic pulmonary oedema b) hemotoxic syndrome - expressed by severe hemolysis of different degrees, in the severe forms - hemolytic shock and anaemia c) hepatal syndrome - characterised by subicterus or icterus, increased liver and bilirubinaemia d) renal syndrome - by oliguria or anuria, pathological deviations in the urine and acute kidney insufficiency. In the extremely severe forms consciousness is disordered. Laboratory blood and urine chemical tests show evidence of phenol metabolites, data for blood damage (increased values of free hemoglobin, reduced number of erythrocytes), positive liver tests etc. 

Damaging processes. The organism is injured by the hemotoxic processes - hemoglobinaemia and severe hemolysis with shock fits, neural, liver and kidney cells metabolism disorders occur. A mild irritative effect on the contact mucosa is also observed. 

Clinical manifestation. It includes the following syndromes a) irritative-pulmotoxic syndrome - with evidence of catarrhal tracheobronchitis, combined with toxic oedema in the severe cases b) cerebral toxic syndrome characterised by ataxia, Menier s syndrome, the severe forms manifest disordered consciousness c) hepatotoxic syndrome - observed in the extremely severe cases of poisoning, manifested as icterus, hepotomegalia and increased blood bilirubin and transaminase values sometimes it is manifested as hepatorenal syndrome d) hemotoxic syndrome - rarely met in acute intoxication by methemoglobinaemia, hemolysis, leukopoenia. 

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