21 September, 2011

Hemiscorpius lepturus sting - a case report

Almost all dangerous scorpions (and all species in the family Buthidae) have neurotoxic venom. Hemiscorpius lepturus Peters, 1861 (Hemiscorpiidae) from Iran and Iraq has a venom composition differing significantly from the species of medical importance in Buthidae (by having a cytotoxic venom). And this species is at least as dangerous as the most potent species in Buthidae, causing renal failure, severe pulmonary hemorrhage and other dangerous conditions in many patients.

Eshan Valavi and co-workers have now published a case report of a Hemiscorpius lepturus sting from Iran describing both symptoms and why the venom causes these potential life threatening symptoms.

Hemiscorpius lepturus is a lethal scorpion with potentially cytotoxic venom. Various degrees of local and systemic toxicity have been observed after its envenomation ranging from local erythema to disseminated intravascular coagulation, renal failure and severe pulmonary hemorrhage. In this case report, we report on a seven-year-old patient who developed the hemolytic uremic syndrome (HUS) after being stung by the scorpion H. lepturus. This condition is characterized by microangiopathic hemolytic anemia, thrombocytopenia, increased serum levels of lactate dehydrogenase and uremia. We evaluated the causes of HUS and found that the levels of C3, C4, CH50 and H factors were normal, but the activity of Von Willebrand factor cleaving protease was decreased (less than 5% of the normal activity). The patient improved after administering therapy with plasma exchange.

Valavi E, Ansari MJ, Hoseini S. ADAMTS-13 deficiency following Hemiscorpius lepturus scorpion sting. Saudi J Kidney Dis Transpl. 2011 Jul-Aug;22(4):792-5. [free fulltext]

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