Azevedo-Marques M M, Cupo P, Coimbra T M, Hering S E, Rossi M A, Laure C J
Toxicon. 1985;23(4):631-6. doi: 10.1016/0041-0101(85)90367-8.
The venom of the Brazilian rattlesnake Crotalus durissus terrificus is know to have hemolytic and neurotoxic physiopathological activities which may cause acute renal failure with hemoglobinuria and/or methemoglobinuria. As far as we know, no report has been published on the ability of the venom of this rattlesnake species to cause rhabdomyolysis. In the present paper we demonstrate that the venom of Brazilian snakes of the genus Crotalus can induce systemic myonecrosis. Clinical, laboratory and anatomo-pathological data for two patients referred to the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo, 24 hr after a rattlesnake bite, are presented. In both cases, exaggerated elevation of serum levels of the enzymes creatine phosphokinase, lactate dehydrogenase and glutamic-oxaloacetic transaminase were detected, as well as data suggesting acute hypercatabolic renal failure. Immunoelectrophoresis of the serum and urine of these patients, carried out against specific anti-myoglobin serum (Behringwerke), demonstrated myoglobinemia and myoglobinuria, confirming injury to muscle tissue. Electron microscopy of a calf muscle biopsy taken from the leg contralateral to the bite from one patient revealed foci of myonecrosis.
已知巴西响尾蛇（Crotalus durissus terrificus）的毒液具有溶血和神经毒性生理病理活性，可能导致伴有血红蛋白尿和/或高铁血红蛋白尿的急性肾衰竭。据我们所知，尚未有关于这种响尾蛇毒液导致横纹肌溶解症能力的报道。在本文中，我们证明了巴西响尾蛇属毒蛇的毒液可诱发全身性肌坏死。本文呈现了两名被响尾蛇咬伤24小时后转诊至圣保罗大学医学院里贝朗普雷图分校大学医院的患者的临床、实验室及解剖病理学数据。在这两个病例中，均检测到血清中肌酸磷酸激酶、乳酸脱氢酶和谷草转氨酶水平的异常升高，以及提示急性分解代谢性肾衰竭的数据。对这些患者的血清和尿液进行针对特异性抗肌红蛋白血清（贝林werke公司）的免疫电泳，证实了肌红蛋白血症和肌红蛋白尿，从而确认了肌肉组织损伤。对其中一名患者咬伤对侧腿部的小腿肌肉活检进行电子显微镜检查，发现了肌坏死灶。
