Persistent fibrinogen deficiency after snake bite: A case report

Table 1 Results of coagulation and fibrinolysis test

Days after bite	PT	INR	FBG	APTT	TT	D-D	FDPs
	11.5-14.5 (s)	0.5-1.2	2.0-4.0 (g/L)	29-42 (s)	14-19 (s)	< 0.5 (μg/L)	< 0.5 (μg/L)
0	> 120	> 10	< 0.5	> 180	> 240	> 60	> 150
1	> 120	> 10	< 0.5	> 180	> 240	> 60	> 150
2	> 120	> 10	< 0.5	> 180	> 240	> 60	> 150
3	> 120	> 10	< 0.5	> 180	> 240	> 60	> 150
4	> 120	> 10	< 0.5	> 180	> 240	> 60	110.5
5	> 120	> 10	< 0.5	> 180	> 240	> 60	83.7
7	> 120	> 10	< 0.5	> 180	236.3	> 60	92.8
11	23.8	2.1	< 0.5	38.8	33.3	27.53	45.3
16	15.2	1.19	0.98	32.6	18.7	2.35	8.8
20	13.7	1.05	1.51	31.4	18.2	0.28	< 4.0
25	13.6	1.04	2.66	32.5	15.5	< 0.22	< 4.0

Day 0: day when the patient was bitten; INR: International normalized ratio; PT: prothrombin time; FBG: fibrinogen; APTT: activated partial thromboplastin time; D-D: D-dimer; FDPs: fibrinogen degradation products; TT: thrombin time.

Table 2 Results of coagulation factor activity level

Days after bite	II	V	VIII	X	XI	XII
	70%-120%	70%-120%	60%-150%	70%-120%	60%-150%	50%-150%
0	55	41	246	59	85	51
4	76	86	150	69	60	44
7	82	79	94	73	79	49
10	95	107	127	89	74	68
15	89	101	112	99	83	72
20	93	86	134	84	96	85
25	113	94	129	105	95	103

Day 0: day when the patient was bitten.

Table 3 Dates and specific doses of replacement therapy

Days after bite	CRYO (u)	FFP (mL)	FBG (g)
0	6	600	0.5
1	16	1600	0.5
2	30.5	3450	1.0
3	11	1900	0.5
4	5	600	1.0
5	—	—	2.0
7	—	—	2.0
9	—	—	2.0
12	—	—	1.0

Day 0: day when the patient was bitten; CRYO: cryoprecipitation; FFP: fresh frozen plasma; FBG: fibrinogen.