ArticlePloS one2013
Brown Recluse spider bite mediated hemolysis: clinical features, a possible role for complement inhibitor therapy, and reduced RBC surface glycophorin A as a potential biomarker of venom exposure.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 30 citations in OpenAlex.
- Clinical Spectrum of Hemolytic Anemia in Loxoscelism: Report of Two Cases Highlighting Variable Severity and Management.Case reports in hematology · 2026Article
- Systemic loxoscelism with hemolysis and positive Coombs: diagnostic and physiopathological implications.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Coagulation abnormalities following brown recluse spider (Loxosceles reclusa) envenomation: A description of 2 cases and review of the literature.American journal of clinical pathology · 2025Review
- Rare Loxoscelism-Associated IgG Coombs-Positive Hemolytic Anemia Treated Successfully With Systemic Corticosteroids.Cureus · 2023Article
- Recurrent deep vein thrombosis following brown recluse spider bite complicated by medication noncompliance and residual scar tissue: A rare case report.Clinical case reports · 2023Article
- Article
- Loxoscelism: Cutaneous and Hematologic Manifestations.Advances in hematology · 2019Article
- Complement System Inhibition Modulates the Pro-Inflammatory Effects of a Snake Venom Metalloproteinase.Frontiers in immunology · 2019Article
- Review
- Defining the complex phenotype of severe systemic loxoscelism using a large electronic health record cohort.PloS one · 2017Article
- Bilateral optic neuropathy following bite from brown recluse spider (Loxosceles reclusa).Cutaneous and ocular toxicology · 2016Article
- The Clinical Pictures of Autoimmune Hemolytic Anemia.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2015Review
- Therapeutic Plasma Exchange for Refractory Hemolysis After Brown Recluse Spider (Loxosceles reclusa) Envenomation.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2015Article
- Diethyl Azelate for the Treatment of Brown Recluse Spider Bite, a Neglected Orphan Indication.In vivo (Athens, Greece)Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe venom of Loxosceles reclusa (Brown Recluse spider) can cause a severe, life-threatening hemolysis in humans for which no therapy is currently available in the USA beyond supportive measures. Because this hemolysis is uncommon, relatively little is known about its clinical manifestation, diagnosis, or management. Here, we aimed to clarify the clinical details of envenomation, to determine the efficacy of the complement inhibitor eculizumab to prevent the hemolysis in vitro, and to investigate markers of exposure to Brown Recluse venom. STUDY DESIGN AND
methodsWe performed a 10-year chart review of cases of Brown Recluse spider bite-mediated hemolysis at our institution. We also designed an in vitro assay to test the efficacy of eculizumab to inhibit hemolysis of venom exposed red blood cells. Finally, we compared levels of CD55, CD59 and glycophorin A on venom exposed versus venom-naïve cells.
resultsMost victims of severe Brown Recluse spider mediated hemolysis at our institution are children and follow an unpredictable clinical course. Brown Recluse spider bite mediated hemolysis is reduced by 79.2% (SD=18.8%) by eculizumab in vitro. Erythrocyte glycophorin A, but not CD55 or CD59, is reduced after red blood cells are incubated with venom in vitro.
conclusionTaken together, our laboratory data and clinical observations indicate that L. reclusa venom exposure results in non-specific antibody and complement fixation on red blood cells, resulting in complement mediated hemolysis that is curtailed by the complement inhibitor eculizumab in vitro. Glycophorin A measurement by flow cytometry may help to identify victims of L. reclusa envenomation.
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