![]() Eculizumab carries FDA labels for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) and has been used off-label to successfully treat other complement-mediated hemolytic processes such as refractory cold agglutinin disease and catastrophic antiphospholipid antibody syndrome in the setting of renal transplantation. However, until eculizumab was approved by the United States Food and Drug Administration (FDA) in 2007, there was no viable complement inhibitor available for clinical use. Previous investigators have shown that BRSB mediated hemolysis is complement dependent. Here, we report the salient clinical and laboratory features of 17 cases of severe BRSB mediated hemolysis – the majority of which were in children – as determined by a 10-year retrospective chart review. In our experience, once BRSB mediated hemolysis becomes clinically apparent it can accelerate rapidly and can be difficult to manage in the absence of a diagnostic test and definitive treatment. The victims we treat are frequently children who follow an unpredictable clinical course requiring inpatient management. reclusa, encounters several cases of severe envenomation per year. Our center, located in the endemic region of L. There are relatively few case reports and recommendations for the management of Brown Recluse spider bite (BRSB) mediated hemolysis. reclusa venom exposure has been described, it is not available for general use. ![]() The severity of injury has led to the consideration of a number of possible treatments such as dapsone, glucocorticoids and hyperbaric oxygen but, none of these has been effective and severely ill patients generally receive only supportive therapy. Envenomation can result in disfiguring dermatonecrosis and/or a fatal hemolytic anemia. reclusa venom is a broadly reactive, 305 amino acid enzyme. reclusa), commonly referred to as the Brown Recluse, is a venomous spider endemic to the southeastern and Midwestern United States.
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