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05:39
Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
Published on: May 16, 2025
Clinical picture and laboratorial evaluation in human loxoscelism
Ceila M S Malaque1, Marcelo L Santoro, João Luiz C Cardoso
1Hospital Vital Brazil, Instituto Butantan, São Paulo-SP, Brazil. cmalaque@butantan.gov.br
Summary
Loxosceles spider bites frequently cause mild hemolysis, with severe complications like acute kidney injury being rare. Laboratory findings indicate hemolysis is common, but overt disseminated intravascular coagulation is not.
Area of Science:
- Toxicology
- Dermatology
- Hematology
Background:
- Loxosceles spiders are globally distributed, with Brazil reporting around 10,000 cases of Loxosceles spp. bites annually.
- Loxoscelism, a condition caused by Loxosceles spider venom, can manifest in cutaneous or cutaneous-hemolytic forms.
Purpose of the Study:
- To analyze clinical and laboratory data of patients with cutaneous or cutaneous-hemolytic loxoscelism.
- To investigate the frequency of hemolysis, anemia, and acute kidney injury (AKI) in loxoscelism.
- To identify factors associated with severe outcomes in Loxosceles spider bite cases.
Main Methods:
- Retrospective analysis of 81 patients diagnosed with loxoscelism.
- Collection of clinical and laboratory data during the first and second week post-bite.
- Assessment of hemolysis markers (serum bilirubin, LDH, reticulocytosis), anemia, thrombocytopenia, D-dimer levels, and AKI.
Main Results:
- Mild hemolysis was frequent, with elevated serum bilirubin and LDH observed in 25 cases.
- Anemia was infrequent (14.7%), while reticulocytosis increased in week 2 (56%).
- Acute kidney injury (AKI) was rare and exclusively observed in patients with massive hemolysis; overt disseminated intravascular coagulation (DIC) was not confirmed on admission.
Conclusions:
- Mild hemolysis is a common finding in loxoscelism.
- Acute kidney injury (AKI) is uncommon and associated with massive hemolysis.
- Fever in loxoscelism patients was significantly associated with the presence of hemolysis.
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