Diagnosis of human envenoming by terrestrial venomous animals: Routine, advances, and perspectives
Joeliton S. Cavalcante,
Sabrina Santana Toledo Arruda,
Pedro Marques Riciopo,
Manuela Pucca,
Rui Seabra Ferreira Junior
Affiliations
Joeliton S. Cavalcante
Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18618-687, São Paulo, Brazil
Sabrina Santana Toledo Arruda
Department of Bioprocess and Biotechnology, School of Agriculture, Agronomic Sciences School, São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18618-687, São Paulo, Brazil
Pedro Marques Riciopo
Department of Bioprocess and Biotechnology, School of Agriculture, Agronomic Sciences School, São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18618-687, São Paulo, Brazil
Manuela Pucca
Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University UNESP—Univ Estadual Paulista, Araraquara, 14800-903, Brazil
Rui Seabra Ferreira Junior
Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18618-687, São Paulo, Brazil; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18610-307, São Paulo, Brazil; Center for Translational Science and Development of Biopharmaceuticals FAPESP/CEVAP-UNESP, Botucatu, 18610-307, São Paulo, Brazil; Corresponding author. Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP—Univ Estadual Paulista), Botucatu, 18618-687, São Paulo, Brazil.
Despite the development of new and advanced diagnostic approaches, monitoring the clinical evolution of accidents caused by venomous animals is still a challenge for science. In this review, we present the state of the art of laboratory tests that are routinely used for the diagnosis and monitoring of envenomings by venomous animals, as well as the use of new tools for more accurate and specific diagnoses. While a comprehensive range of tools is outlined, comprising hematological, biochemical, immunoassays, and diagnostic imaging tools, it is important to acknowledge their limitations in predicting the onset of clinical complications, since they provide an overview of organic damage after its development. Thus, the need for discovery, validation, and use of biomarkers that have greater predictive power, sensitivity and specificity is evident. This will help in the diagnosis, monitoring, and treatment of patients envenomated by venomous animals, consequently reducing the global burden of morbidity and mortality.