To clarify the characteristics of the hematological disturbances evoked by
snakebite, we measured the
antithrombin III (AT-III) activity, alpha2-plasmin inhibitor (alpha2-PI) activity,
fibrinogen concentration (Fg) and level of
fibrin degradation products (
FDP) in 21 patients envenomed by several snakes in south China between August 1998 and October 1999. The hematological changes observed were as follows: the mean activities of AT-III were decreased in patients bitten by Ophiophagus hannah (
Oh.), Bungarus fasciatus (Bf.), Hydrophis cyanocinctus (Hc.), Rhabdophis subminiatus (Rs.), and Trimeresurus stejnegeri (Ts.), while those of alpha2-PI were decreased in all patients in the present study; Fg was not detectable in the case of Rs.
bite, and the Fg concentration after Ts.,
Oh., Hc. and Bf.
bites also decreased markedly thereby increasing the mean levels of
FDP in all patients. It thus appeared that
DIC-like syndrome was caused in patients envenomed by
snakebite. In the present study, we found that patients who were bitten by Rs., which is still being classified as a non-venomous snake, exhibited complete defibrinogenation and severe
hemorrhage without any evidence of severe multiple organ damage. We also found that patients with Ts.
bite showed marked
hemostatic disturbance without severe multiple organ damage. It is considered that such a discrepancy between the hematological findings and clinical symptoms could be a characteristic phenomenon of the
DIC-like syndrome induced by
snakebite, especially by Rs. and Ts.
bites.