Pathogenesis of hemorrhage induced by proteinase H from eastern diamondback rattlesnake (Crotalus adamanteus) venom

The systemic effects of a purified hemorrhagic toxin, proteinase H, from Crotalus adamanteus venom, were studied. Female, white CD-1 mice were injected intravenously with proteinase H and tissue samples were obtained at 1, 3 and 24 hr after injection. Hemorrhage was observed grossly within 1 hr in several internal organs including the stomach and small intestine, the heart and the lungs. Surface discolorations thought to be petechial hemorrhages were observed in the kidneys. The livers of treated animals were visibly swollen and darkened and lobules were accentuated. Tissue samples were taken from the stomach, duodenum, heart, lungs, liver and kidneys and prepared for observation by light and electron microscopy. Frank hemorrhage was observed by light microscopy in the walls of the stomach and duodenum, in the myocardium and in the lungs. Pulmonary hemorrhage was severe, with involvement of nearly all of the pulmonary tissue within 3 hr. A1 doses of 5 micrograms/g, hepatic degeneration was observed by 3 hr. Renal glomeruli were noticeably swollen and the lumena of the proximal convoluted tubules indistinct. Closer examination by electron microscopy revealed that the endothelial cells comprising the fenestrated glomerular capillaries remained intact but signs of degeneration (i.e. cytoplasmic swelling and mitochondrial swelling) were observed. Proteinase H induces systemic hemorrhage in the heart, lungs, stomach and small intestine, renal glomerulonephropathy and hepatic degeneration.