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Resumen Introducción: dentro de los insectos del orden lepidóptero, la familia Saturniidae tiene más de 2.400 especies, allí se encuentran Hylesia y Lonomia. Objetivo: presentar dos casos de pacientes con accidente lonómico, el manejo y desenlace para reconocer la importancia de estos eventos en las regiones silvestres de la Orinoquia colombiana. Casos clínicos: paciente de 8 años proveniente de área rural quien refería contacto en región palmar de mano derecha con gusanos quién 48 horas después de dicho contacto presentó equimosis en extremidades, flictena sangrante en talón derecho, cefalea, escalofríos y artralgias, además se evidenciaron tiempos de coagulación prolongados. Paciente de 13 años de características similares a las del caso previamente descrito sin presentar manifestaciones clínicas, pero que presentaba tiempos de coagulación prolongados. Se consideró que cursaba con accidente lonómico por lo que se aplicaron 5 ampollas de suero antilonómico polivalente a cada una sin registrar reacciones adversas. En ambos casos cursaron con evolución clínica adecuada con disminución a rangos de seguridad de tiempos de coagulación. Conclusiones: el veneno lonómico actúa en la cascada de coagulación produciendo manifestaciones hemorrágicas de gravedad variable. El suero antilonómico es el único tratamiento eficaz, a pesar de estar disponible desde hace más de 20 años en Brasil hay un 5% de progresión a síndromes hemorrágicos severos y un 1.5 a 2% de mortalidad. A pesar de tener gran relevancia clínica en las Américas existe subregistro, es importante conocer sus manifestaciones y el manejo para así poder evitar complicaciones mortales. Abstract Background: among the insects of the order Lepidoptera, the family Saturniidae has more than 2,400 species, there are Hylesia and Lonomia. Objective: to present two cases of patients with lonomic accident, the management and outcome to recognize the importance of these events in the wild regions of the Colombian orinoquia. Clinical case: an 8-year-old patient from a rural area who refers to contact in the palmar region of the right hand with worms for more than 48 hours, presents ecchymosis in the extremities, bleeding flictena in the right heel, headache, chills and arthralgias. Clotting times are performed which are prolonged. A 13-year-old patient who also referred contact without presenting clinical manifestations but presenting prolonged clotting times. They are considered to occur due to a lonomic accident, so 5 ampoules of polyvalent antilonomic serum are administered to each one without registering adverse reactions. They have an adequate clinical evolution with a decrease in the safe ranges of clotting times. Conclusions: the lonomic venom acts in the coagulation cascade producing hemorrhagic manifestations of variable severity. Antilonomic serum is the only effective treatment, despite being available for more than 20 years in Brazil, there is a 5% progression to severe hemorrhagic syndromes and 1.5 to 2% mortality. Despite being of great clinical relevance in the Americas, there is an underreporting, it is important to know its manifestations and management in order to avoid fatal complications.

The accidents caused by the larval stages of the Lepidoptera are known as erucism. Accidental contact with caterpillars of the genus Lonomia spp. can trigger hemorrhagic syndromes that in severe cases can lead to acute renal injury and intracranial hemorrhage. We present the case of a 48 year-old male from Peruvian Central Jungle who while was working in the forest comes in contact with a caterpillar, after which he developed an hemorrhagic syndrome characterized by coagulopathy and subarachnoid hemorrhage. The clinical picture resolved satisfactorily after administration of antilonomic serum. The pathophysiological, clinical and laboratory aspects that led to the diagnosis are discussed, as well as the reported effectiveness of treatment. Los accidentes causados por los estadios larvarios de los lepidópteros se conocen como erucismo. El contacto accidental con las orugas del género Lonomia spp. puede desencadenar síndromes hemorrágicos que en casos severos puede llegar a producir injuria renal aguda y hemorragia intracraneal. Se presenta el caso de un varón de 48 años procedente la selva central del Perú, quien mientras estaba en el campo, incidentalmente entra en contacto con una oruga, cursando luego con un síndrome hemorrágico caracterizado por coagulopatía y hemorragia subaracnoidea. El cuadro se resolvió satisfactoriamente luego de la administración del suero antilonómico. Se discute los aspectos fisiopatológicos, clínicos y laboratoriales que condujeron al diagnóstico, así como la efectividad reportada del tratamiento.

Lonomia parobliqua Brechlin, Meister & Mielke, 2011 *. (Fig. 1) Lonomia parobliqua Brechlin, Meister & Mielke, 2011: 69, figs 25, 26, 31. D��TERMINATION. ��� Morphologique.Mol��culaire (BOLD: AAB 4043). LOCALIT�� TYPE. ��� Paraguay: Alto Paran�� (Brechlin et al. 2011). HISTORIQUE. ��� Pr��c��demment signal�� sur guianensis.fr comme Lonomia obliqua Walker, 1855. R��PARTITION G��OGRAPHIQUE. ��� Paraguay, Argentine, Br��sil (Brechlin et al. 2011). DISTRIBUTION EN GUYANE. ��� Littoral (Sinnamary) et Int��rieur (Mitaraka). HABITAT EN GUYANE. ��� M��connu. MAT��RIEL DU MITARAKA EXAMIN��. ��� Guyane ��� 1 ♀ barcod��e CO1-AE6 (BOLD: AAB 4043); Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; autorisation APA-973-2; 11-21. VIII.2015; FB leg.; MNHN., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 772, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817

Lonomia parobliqua Brechlin, Meister & Mielke, 2011 *. (Fig. 1) Lonomia parobliqua Brechlin, Meister & Mielke, 2011: 69, figs 25, 26, 31. DÉTERMINATION. — Morphologique.Moléculaire (BOLD: AAB 4043). LOCALITÉ TYPE. — Paraguay: Alto Paraná (Brechlin et al. 2011). HISTORIQUE. — Précédemment signalé sur guianensis.fr comme Lonomia obliqua Walker, 1855. RÉPARTITION GÉOGRAPHIQUE. — Paraguay, Argentine, Brésil (Brechlin et al. 2011). DISTRIBUTION EN GUYANE. — Littoral (Sinnamary) et Intérieur (Mitaraka). HABITAT EN GUYANE. — Méconnu. MATÉRIEL DU MITARAKA EXAMINÉ. — Guyane • 1 ♀ barcodée CO1-AE6 (BOLD: AAB 4043); Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; autorisation APA-973-2; 11-21. VIII.2015; FB leg.; MNHN.

Lonomia rubroguyana Brechlin & Meister, 2019. (Fig. 2) Lonomia rubroguyana Brechlin & Meister, 2019: 15, figs 9, 10, 11, 21. D��TERMINATION. ��� Morphologique. Mol��culaire (BOLD: AAB 0790, ACV 3238). LOCALIT�� TYPE. ��� Guyane (Brechlin & Meister 2019). HISTORIQUE. ��� Pr��c��demment cit�� de Guyane comme Lonomia descimoni Lemaire, 1972 (Lemaire 2002). R��PARTITION G��OGRAPHIQUE. ��� Guyane (Brechlin & Meister 2019). DISTRIBUTION EN GUYANE. ��� Connu des trois zones biog��ographiques. HABITAT EN GUYANE. ��� For��t primaire. MAT��RIEL DU MITARAKA EXAMIN��. ��� Guyane ��� 2 ♂ barcod��s CO1-AE7 et CO1-AF1 (BOLD: ACV 3238); Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; autorisation APA-973-2; 11-21.VIII.2015; FB leg.; MNHN ��� 2 ♂ barcod��s CO1-AF2 et CO1-AF3; m��mes donn��es que pr��c��dent; MNHN., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 773, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817, {"references":["BRECHLIN R. & MEISTER F. 2019. - Drie neue Arten der Gattung Lonomia Walker, 1855 aus dem nordlichen Sudamerika (Lepidoptera: Saturniidae). Entomo-Satsphingia 12 (3): 13 - 20.","LEMAIRE C. 1972. - Descriptions d'Attacidae nouveaux d'Amerique centrale et du Sud [Lep.]. Bulletin de la Societe entomologique de France 76 (1971): 197 - 207, 1 fig. https: // doi. org / 10.3406 / bsef. 1971.21210","LEMAIRE C. 2002. - The Saturniidae of America. Les Saturniidae Americains (= Attacidae). Hemileucinae. Goecke & Evers, Keltern. Vol. 1: [1] - 688; Vol. 2: 689 - 1388; Vol. 3: pl. phot. 1 - 126."]}

Lonomia achelous (Cramer, 1777), stat. rev.. (Fig. 3C) Phalaena Attacus achelous Cramer, 1777: 22, pl. 111, fig. A. Lonomia achelous [achelous] – Draudt 1929: 763. DÉTERMINATION. — Morphologique.Moléculaire (BOLD:ADG261). LOCALITÉ TYPE. — West Indies (Cramer 1777). Suriname (Lemaire 1973a). REMARQUE TAXONOMIQUE. — Des différences morphologiques et les données génétiques (3,5% de divergence minimale entre les codes-barres ADN de spécimens des deux taxons, et chacun d’eux étant plus proche génétiquement d’autres espèces du genre Lonomia [R. Rougerie, com. pers.]) attestent que Lonomia achelous achelous et Lonomia achelous diabolus sont deux espèces distinctes et justifient le nouveau statut du taxon. DISTRIBUTION EN GUYANE. — Connu des trois zones biogéographiques. HABITAT EN GUYANE. — Forêt primaire. MATÉRIEL DU MITARAKA EXAMINÉ. — Guyane • 1 ♂; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN • 1♂; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; autorisation APA-973-2; 11-21.VIII.2015; FB leg.; Coll. FB.

Lonomia cayennensis Brechlin & Meister, 2019. (Fig. 3A, B) Lonomia cayennensis Brechlin & Meister, 2019: 14, fig. 4. D��TERMINATION. ��� Morphologique. Mol��culaire (BOLD: AAB 0796). LOCALIT�� TYPE. ��� Guyane (Brechlin & Meister 2019). R��PARTITION G��OGRAPHIQUE. ��� Guyane (Brechlin & Meister 2019). Suriname (FB, obs. pers.). DISTRIBUTION EN GUYANE. ��� Connu des trois zones biog��ographiques. HABITAT EN GUYANE. ��� For��ts primaire et secondaire. MAT��RIEL DU MITARAKA EXAMIN��. ��� Guyane ��� 1 ♂ 1 ♀; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN ��� 1 ♂; m��mes donn��es que pr��c��dent; Coll. FB., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 774, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817, {"references":["BRECHLIN R. & MEISTER F. 2019. - Drie neue Arten der Gattung Lonomia Walker, 1855 aus dem nordlichen Sudamerika (Lepidoptera: Saturniidae). Entomo-Satsphingia 12 (3): 13 - 20."]}

Lonomia belizonensis Brechlin, Meister & van Schayck, 2011. Lonomia belizonensis Brechlin, Meister & van Schayck, 2011: 69, fig. 18. D��TERMINATION. ��� Morphologique.Mol��culaire (BOLD: AAB 0791). LOCALIT�� TYPE. ��� Guyane (Brechlin et al. 2011). HISTORIQUE. ��� Pr��c��demment cit�� de Guyane comme Lonomia descimoni Lemaire, 1972 (Lemaire 2002). R��PARTITION G��OGRAPHIQUE. ��� Guyane (Brechlin et al. 2011). Br��sil (Par��): San Ant��nio do Tau�� (BOLD). DISTRIBUTION EN GUYANE. ��� Connu des trois zones biog��ographiques. HABITAT EN GUYANE. ��� For��t primaire. MAT��RIEL DU MITARAKA EXAMIN��. ��� Guyane ��� 3♂, 3 ♀; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN ��� 2 ♂ 2 ♀; m��mes donn��es que pr��c��dent; Coll. FB., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 773, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817, {"references":["BRECHLIN R., MEISTER F. & VAN SCHAYCK E. 2011. - Neue Taxa der Gattung Automeris Hubner, [1819] (Lepidoptera: Saturniidae). Entomo-Satsphingia 4 (2): 16 - 29.","LEMAIRE C. 1972. - Descriptions d'Attacidae nouveaux d'Amerique centrale et du Sud [Lep.]. Bulletin de la Societe entomologique de France 76 (1971): 197 - 207, 1 fig. https: // doi. org / 10.3406 / bsef. 1971.21210","LEMAIRE C. 2002. - The Saturniidae of America. Les Saturniidae Americains (= Attacidae). Hemileucinae. Goecke & Evers, Keltern. Vol. 1: [1] - 688; Vol. 2: 689 - 1388; Vol. 3: pl. phot. 1 - 126."]}

Lonomia cayennensis Brechlin & Meister, 2019. (Fig. 3A, B) Lonomia cayennensis Brechlin & Meister, 2019: 14, fig. 4. DÉTERMINATION. — Morphologique. Moléculaire (BOLD: AAB 0796). LOCALITÉ TYPE. — Guyane (Brechlin & Meister 2019). RÉPARTITION GÉOGRAPHIQUE. — Guyane (Brechlin & Meister 2019). Suriname (FB, obs. pers.). DISTRIBUTION EN GUYANE. — Connu des trois zones biogéographiques. HABITAT EN GUYANE. — Forêts primaire et secondaire. MATÉRIEL DU MITARAKA EXAMINÉ. — Guyane • 1 ♂ 1 ♀; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN • 1 ♂; mêmes données que précédent; Coll. FB.

Lonomia achelous (Cramer, 1777), stat. rev.. (Fig. 3C) Phalaena Attacus achelous Cramer, 1777: 22, pl. 111, fig. A. Lonomia achelous [achelous] ��� Draudt 1929: 763. D��TERMINATION. ��� Morphologique.Mol��culaire (BOLD:ADG261). LOCALIT�� TYPE. ��� West Indies (Cramer 1777). Suriname (Lemaire 1973a). REMARQUE TAXONOMIQUE. ��� Des diff��rences morphologiques et les donn��es g��n��tiques (3,5% de divergence minimale entre les codes-barres ADN de sp��cimens des deux taxons, et chacun d���eux ��tant plus proche g��n��tiquement d���autres esp��ces du genre Lonomia [R. Rougerie, com. pers.]) attestent que Lonomia achelous achelous et Lonomia achelous diabolus sont deux esp��ces distinctes et justifient le nouveau statut du taxon. DISTRIBUTION EN GUYANE. ��� Connu des trois zones biog��ographiques. HABITAT EN GUYANE. ��� For��t primaire. MAT��RIEL DU MITARAKA EXAMIN��. ��� Guyane ��� 1 ♂; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN ��� 1♂; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2��14���1.9���N, 54��27���38.1���W; La Plan��te revisit��e, MNHN / PNI Guyane; autorisation APA-973-2; 11-21.VIII.2015; FB leg.; Coll. FB., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 774, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817, {"references":["DRAUDT M. 1929 - 1930. - 12 Familie: Saturnidae [sic], in SEITZ A. (Ed.), Die Gross-Schmetterlinge der Erde 6. A. Kernen, Stuttgart. (Die amerikanischen Spinner und Schwarmer): 713 - 827, pl. col. h. - t. 101 - 137, 142. https: // www. biodiversitylibrary. org / page / 12779669","LEMAIRE C. 1973 a. - Revision du genre Automeris Hubner et des genres voisins. Biogeographie, Ethologie, Morphologie, Taxonomie (Lep. Attacidae). Memoires du Museum national d'Histoire naturelle (Paris) (A) Zool. - 1971 [fasc. 2] 79: 233 - 422, fig. 133 - 278, pl. 30 - 49. - 1974 [suite et fin, fasc. 3] ibidem 92: 423 - 576, fig. 279 - 370, pl. 50 - 61"]}

Lonomia rubroguyana Brechlin & Meister, 2019. (Fig. 2) Lonomia rubroguyana Brechlin & Meister, 2019: 15, figs 9, 10, 11, 21. DÉTERMINATION. — Morphologique. Moléculaire (BOLD: AAB 0790, ACV 3238). LOCALITÉ TYPE. — Guyane (Brechlin & Meister 2019). HISTORIQUE. — Précédemment cité de Guyane comme Lonomia descimoni Lemaire, 1972 (Lemaire 2002). RÉPARTITION GÉOGRAPHIQUE. — Guyane (Brechlin & Meister 2019). DISTRIBUTION EN GUYANE. — Connu des trois zones biogéographiques. HABITAT EN GUYANE. — Forêt primaire. MATÉRIEL DU MITARAKA EXAMINÉ. — Guyane • 2 ♂ barcodés CO1-AE7 et CO1-AF1 (BOLD: ACV 3238); Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; autorisation APA-973-2; 11-21.VIII.2015; FB leg.; MNHN • 2 ♂ barcodés CO1-AF2 et CO1-AF3; mêmes données que précédent; MNHN.

Lonomia diabolus Draudt, 1929, stat. rev.. Lonomia diabolus (Oxytenis diabolus Maassen i. l.) Draudt, 1929: 763, pl. 119, fig. d. Lonomia achelous diabolus ��� Lemaire 1996: 35, no. 224b. D��TERMINATION. ��� Morphologique.Mol��culaire (BOLD: AAB 4840). LOCALIT�� TYPE. ��� Guyane (Lemaire 1973a). R��PARTITION G��OGRAPHIQUE. ��� Guyano-amazonienne (Lemaire 2002). REMARQUE TAXONOMIQUE. ��� Des diff��rences morphologiques et les donn��es g��n��tiques (3,5 % de divergence minimale entre les codesbarres ADN de sp��cimens des deux taxons, et chacun d���eux ��tant plus proche g��n��tiquement d���autres esp��ces du genre Lonomia [R. Rougerie, com. pers.]) attestent que Lonomia achelous diabolus et Lonomia achelous achelous sont deux esp��ces distinctes et justifient le nouveau statut du taxon. DISTRIBUTION EN GUYANE. ��� Connu des trois zones biog��ographiques. HABITAT EN GUYANE. ��� For��ts primaire et secondaire, zones anthropis��es. REMARQUE. ��� Esp��ce observ��e, mais non collect��e lors de la mission APA-973-2 (FB)., Published as part of B��n��luz, Fr��d��ric, 2021, Liste comment��e des Saturniidae (Lepidoptera, Bombycoidea) de Guyane, avec la liste des taxons r��colt��s au Mitaraka (extr��me sud-ouest guyanais), pp. 759-809 in Zoosystema 43 (31) on page 774, DOI: 10.5252/zoosystema2021v43a31, http://zenodo.org/record/5796817, {"references":["DRAUDT M. 1929 - 1930. - 12 Familie: Saturnidae [sic], in SEITZ A. (Ed.), Die Gross-Schmetterlinge der Erde 6. A. Kernen, Stuttgart. (Die amerikanischen Spinner und Schwarmer): 713 - 827, pl. col. h. - t. 101 - 137, 142. https: // www. biodiversitylibrary. org / page / 12779669","LEMAIRE C. 1996. - Saturniidae. in HEPPNER J. B. (Ed) et al. Atlas of Neotropical Lepidoptera. Association for Tropical Lepidoptera & Scientific Publishers. Gainesville, Florida. Checklist: Part 4 B (Drepanoidea-Bombycoidea-Sphingoidea): 28 - 49; 61 - 84.","LEMAIRE C. 1973 a. - Revision du genre Automeris Hubner et des genres voisins. Biogeographie, Ethologie, Morphologie, Taxonomie (Lep. Attacidae). Memoires du Museum national d'Histoire naturelle (Paris) (A) Zool. - 1971 [fasc. 2] 79: 233 - 422, fig. 133 - 278, pl. 30 - 49. - 1974 [suite et fin, fasc. 3] ibidem 92: 423 - 576, fig. 279 - 370, pl. 50 - 61","LEMAIRE C. 2002. - The Saturniidae of America. Les Saturniidae Americains (= Attacidae). Hemileucinae. Goecke & Evers, Keltern. Vol. 1: [1] - 688; Vol. 2: 689 - 1388; Vol. 3: pl. phot. 1 - 126."]}

Lonomia belizonensis Brechlin, Meister & van Schayck, 2011. Lonomia belizonensis Brechlin, Meister & van Schayck, 2011: 69, fig. 18. DÉTERMINATION. — Morphologique.Moléculaire (BOLD: AAB 0791). LOCALITÉ TYPE. — Guyane (Brechlin et al. 2011). HISTORIQUE. — Précédemment cité de Guyane comme Lonomia descimoni Lemaire, 1972 (Lemaire 2002). RÉPARTITION GÉOGRAPHIQUE. — Guyane (Brechlin et al. 2011). Brésil (Pará): San Antônio do Tauá (BOLD). DISTRIBUTION EN GUYANE. — Connu des trois zones biogéographiques. HABITAT EN GUYANE. — Forêt primaire. MATÉRIEL DU MITARAKA EXAMINÉ. — Guyane • 3♂, 3 ♀; Maripasoula, Mitaraka, Crique Alama (DZ); alt. 310 m; 2°14’1.9”N, 54°27’38.1”W; La Planète revisitée, MNHN / PNI Guyane; APA-973-1; 23.II-26. III.2015; E. Poirier leg.; MNHN • 2 ♂ 2 ♀; mêmes données que précédent; Coll. FB.

The significant incidence of deforestation in South America culminates in the contact of humans with typical forests species. Among these species, one may highlight Lonomia obliqua caterpillar, which, when touched by humans, can poison them through their bristles. Therefore, better acknowledging the mechanisms involved in envenomation caused by Lonomia obliqua caterpillar bristle extract (LOCBE) may contribute to further treatments. Recently, we demonstrated that LOCBE induces a pro-inflammatory profile in endothelial cells; thus, we decided to investigate the effects of LOCBE on human polymorphonuclear neutrophils (PMN), which are the first leukocytes that migrate to the inflammatory focus. Our results showed that treatment with LOCBE induced PMN chemotaxis together with alterations in actin cytoskeleton and focal adhesion kinase (FAK) activation, favoring migration. Concurrently, LOCBE induced PMN adhesion to matrix proteins, such as collagen IV, fibronectin, and fibrinogen. Moreover, we observed that LOCBE attenuated PMN apoptosis and increased reactive oxygen species (ROS) production together with nuclear factor kB (NF-κB) activation—a redox-sensitive transcription factor—as well as interleukin (IL)-1β and IL-8 release. We call attention to the ROS-dependent effect of LOCBE on increased cell migration once an antioxidant treatment reverted it. In summary, we report that LOCBE activates PMN, inducing pro-inflammatory responses modulated by ROS.

Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: “Acute kidney injury” or “Venom” and “Inflammation” on Medline/Pubmed and Google Scholar; “Kidney disease” or “Acute kidney injury” on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

Background Envenomation by the South American Lonomia saturniid caterpillars, named lonomism, constitutes an emerging and somewhat neglected public health issue in Argentina and neighboring countries. Considering that there is an intricate relationship between environment and human health in such cases, this study aimed to analyze the eco-epidemiological profile of 40 accidents and 33 occurrences of Lonomia spp. in Misiones (Argentina) between January 2014 and May 2020. Methodology/Principal findings We described the eco-epidemiological variables and characterized the abiotic scenario of such cases. Additionally, we obtained a density map that shows the punctual intensity of Lonomia records throughout Misiones. Most of the accidents occurred in the Department of Guaraní and involved male victims younger than 20 years old. The accidental/occasional occurrence of Lonomia spp. (considering both adult and caterpillar stages together) was significantly higher in the rural area, whereas only adult specimens were found in urban areas. We determined that the presence of this insect in Misiones is positively related to higher temperatures and solar radiation, and larger precipitation and evapotranspiration throughout the year. Conclusion/Significance This study represents an initial step towards the global understanding of lonomism as a public health problem in Argentina. It provides a map of the risk level for this envenomation in Misiones, which could help authorities address public health policy efforts to implement sustainable strategies for prevention and response to this threat in Northeastern Argentina and neighboring regions., Author summary Caterpillars of the genus Lonomia (Saturniidae: Hemileucinae) are considered the world’s most deadly lepidopterans. Due to the increasing number of cases and the lack of antivenom therapy, envenomation by these animals constitutes an emerging and somewhat neglected public health issue in Argentina and neighboring countries. Our research has determined the eco-epidemiological scenario of such an envenomation in the Argentine province of Misiones–mainly covered by the Atlantic Forest (a suitable biome for L. obliqua)–, and identified some predictors to occurrences/accidents with this insect. This study also provides the first map of the potential risk of lonomism in this province, which has several natural attractions visited by millions of tourists worldwide. We discussed our findings in light of immediate response from health authorities to outline preventive strategies for accidents and conservation of this venomous lepidopteran in its ecological niche.

Caterpillars of the genus Lonomia (family Saturniidae) are covered in scoli filled with venom. The venom is capable of producing hemorrhagic syndrome in humans that can lead patients to develop kidney failure, brain damage and, in severe cases, death. Accidents have been attributed to two species, however, genetic identification of caterpillars associated to accidents in Colombia have led to the discovery of at least three different species capable of produce hemorrhagic syndromes. Phylogenetic relationships among these species and their venom¿s action mechanism are still unknown. Under this context, the objectives of this thesis were to: (1) propose a time-calibrated phylogeny for the genus Lonomia (2) evaluate altered metabolites of cells exposed to venom from different species of Lonomia. To achieve the first objective, we sequenced ultraconserved elements (UCEs) from Lonomia samples representing 48 different species and reconstruct the phylogeny. The phylogeny obtained is nearly comprehensive and supports the division of the genus into three species-groups and an additional lineage represented by Lonomia beneluzi. Our phylogenetic hypothesis reveals that the species involved in human envenomation are not monophyletic and belong to both the achelous- and obliqua-group suggesting that more species of Lonomia may be involved in human accidents. To achieve the second objective, VERO cells were exposed to venom of 3 Lonomia species: L. casanarensis, L. orientoandensis and L. orientocordillera. We used a concentration of 30 ?g/ml and two exposure times (2h and 24h). Metabolites of VERO cells were extracted and measured using liquid chromatography coupled to high resolution-mass spectrometry. We were able to identify 96 altered metabolites. We found a downregulation of glutathione and upregulation of prostaglandins in cells exposed to the venoms of L. orientocordillera and L. casanarensis suggesting their capability to cause oxidative stress and inflammation. Las orugas del género Lonomia (familia Saturniidae) poseen espinas llenas de veneno capaz de producir un síndrome hemorrágico en humanos que puede conducir a insuficiencia renal, daño cerebral y, en casos severos, a la muerte. Los accidentes han sido atribuidos a dos especies. Sin embargo, mediante la identificación molecular de orugas asociadas a accidentes en Colombia se han encontrado al menos tres especies diferentes capaces de producir síndromes hemorrágicos. Las relaciones filogenéticas entre estas especies y el mecanismo de acción de sus venenos aún se desconocen. Bajo este contexto, se plantearon dos objetivos: (1) proponer una filogenia para el género Lonomia y (2) evaluar los metabolitos alterados en células expuestas al veneno de diferentes especies de Lonomia. Para el primer objetivo se muestrearon 48 especies diferentes y se reconstruyo la filogenia usando Elementos Ultraconservados y máxima verosimilitud. Se obtuvo una filogenia casi completa que apoya la división del género en tres grupos de especies y un linaje adicional representado por Lonomia beneluzi. Nuestra filogenia revela que las especies involucradas en el envenenamiento humano no son monofiléticas y pertenecen tanto al grupo achelous como al obliqua. Esto sugiere que más especies podrían estar involucradas en los accidentes. Para el segundo objetivo se expusieron células VERO al veneno de 3 especies: L. casanarensis, L. orientoandensis y L. orientocordillera. La concentración de los venenos fue de 30 ?g/ml y se evaluaron dos tiempos de exposición (2h y 24h). Los metabolitos de las células se extrajeron y midieron mediante cromatografía líquida acoplada a espectrometría de masas de alta resolución. Se identificaron 96 metabolitos alterados, dentro de los cuales se encontró una disminución de glutatión y un incremento de prostaglandinas en las células expuestas a los venenos de L. orientocordillera y L. casanarensis. Esto apoya su capacidad para causar estrés oxidativo e inflamación. Magíster en Ciencias Biológicas Maestría

Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: “Acute kidney injury” or “Venom” and “Inflammation” on Medline/Pubmed and Google Scholar; “Kidney disease” or “Acute kidney injury” on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

Background Among the Lepidoptera with medical importance in Brazil, larvae of Lonomia moth (Saturniidae: Hemileucinae) stand out by being the etiological agent of the lonomism, a form of erucism in which the most troubling symptoms include systemic hemorrhage that can lead to death. Methods This study provides an epidemiological overview of accident notifications with Lonomia registered by the Brazilian Reportable Disease Information System (SINAN) between 2007 and 2018. The categories of sociodemographic aspects of the victim, accident characteristics, and clinical data (6,636 records) were analysed by the chi-square test for goodness of fit (α=0.05). By the same test, accident frequencies by month, year, and state were also compared. To explore the spatial distribution of notifications and to identify significant space-time and purely spatial clusters, a spatial scan statistic (SaTScan) was used. Results The epidemiological profile of most of the victims had at least one of the following characteristics: male, >50 y of age, ethnically classified as white, and with a low level of education. Accidents in urban areas were as frequent as in rural areas. A higher frequency of non-work-related accidents was detected. Victims were mostly stung on the upper limbs. Most victims received medical care within the first 3 h after the accident. Most cases were classified as mild, although 12 deaths were reported. The south states of Brazil concentrate the highest frequencies of notifications. Summer was the season with the greatest number of cases, and the majority of the notifications occurred between 2017 and 2018. Conclusion These results provide an overall and current situation assessment of the lonomism in Brazil, and they should enable health authorities to improve the management of this envenomation in states/regions that share the high epidemiological risk of exposure to Lonomia.

Caterpillar envenomation is a global health threat in the 21st century. Every direct or indirect contact with the urticating hairs of a caterpillar results in clinical manifestations ranging from local dermatitis symptoms to potentially life-threatening systemic effects. This is mainly due to the action of bioactive components in the venom that interfere with targets in the human body. The problem is that doctors are limited to relieve symptoms, since an effective treatment is still lacking. Only for Lonomia species an effective antivenom does exist. The health and economical damage are an underestimated problem and will be even more of a concern in the future. For some caterpillar species, the venom composition has been the subject of investigation, while for many others it remains unknown. Moreover, the targets involved in the pathophysiology are poorly understood. This review aims to give an overview of the knowledge we have today on the venom composition of different caterpillar species along with their pharmacological targets. Epidemiology, mode of action, clinical time course and treatments are also addressed. Finally, we briefly discuss the future perspectives that may open the doors for future research in the world of caterpillar toxins to find an adequate treatment. ispartof: BIOMEDICINES vol:8 issue:6 ispartof: location:Switzerland status: published

Introduction The envenomation by Lonomia species mainly occur in rural areas. The main symptom of this condition is an alteration in the clotting times and hemorrhage. However, acute kidney injury is been also identified in some case reports. Therefore, it should not be disregarded and to understand the pathophysiological mechanism, diagnosis and treatment of this clinical feature results necessary in order to expand awareness and to prevent further medical complications and death. Materials and Methods We present a case report and scoping review of the literature to characterize patients with acute kidney injury secondary to Lonomia envenomation by a case report and describing the pathophysiology, diagnosis, treatment and prognosis of patients suffering from this condition. The information was obtained from 4 databases: Medline, Embase, LILACs and Ovid. We used the following search strategy: (((“Acute Kidney Injury” [Mesh]) AND “lonofibrase” [Supplementary Concept]) OR lonomy accident) OR lonomia. Results We identified ten case reports of Lonomia spp. Envenomation, nine of them were caused by L. obliqua and one by L. achelous. A cohort study that included 37 patients who were exposed to the L. obliqua venom was also included. All patients were adults, lived in the countryside and developed acute kidney injury. Conclusions Acute kidney injury has been identified as one important clinical feature of the Lonomia envenomation. The development of this condition is mediated by various pathophysiological mechanisms. To perform an adequate diagnosis, coagulation times, fibrinogen levels, hemogram, kidney function and urinalysis should be done. The definitive treatment depends on the type of envenomation. The prognosis for these patients is not well described yet. However, our patient had a good response to the described management given.

Introdução. A perda gestacional recorrente (PGR) está associada à morbidade física e psicológica grave, para a qual, quando se excluem causas anatômicas e genéticas, não há opções de tratamento. A fisiopatologia envolve a deficiência nas capacidades de proliferação e migração das células do estroma endometrial (hESCs), prejudicando a implantação e o desenvolvimento do embrião. Por isso, encontrar novas moléculas citoprotetoras capazes de estimular a proliferação de hESCs pode ser interessante. Uma vez que os venenos de animais são fontes ricas em moléculas bioativas, neste trabalho objetivamos caracterizar os efeitos citoprotetores do veneno da Lonomia obliqua em hESCs. Metodologia. hESCs foram isoladas de biópsias endometriais humanas frescas e caracterizadas de acordo com protocolos padrão. Em seguida, os efeitos das secreções venenosas de L. obliqua sobre a viabilidade, proliferação e migração celular foram determinados. Os componentes do veneno envolvidos nos efeitos de proliferação celular também foram identificados por métodos cromatográficos clássicos e análises proteômicas. Resultados. O veneno de L. obliqua induz a proliferação, viabilidade e migração de hESC de uma maneira dependente da dose, tanto na presença como nas condições de privação de soro. Por cromatografia de troca iônica foi obtida uma fração enriquecida em componentes citoprotetores desprovidos de efeito hemotóxico. A análise proteômica do veneno identificou pelo menos seis classes de proteínas com propriedades citoprotetoras potenciais (hemolinas, lipocalinas, hemocianinas, proteínas antivirais, peptídeos antimicrobianos e inibidores de protease). O mecanismo envolvido na citoproteção parece estar relacionado à regulação negativa da geração do ânion superóxido, aumento das enzimas antioxidantes, produção de óxido nítrico e ativação de vias de proliferação dependentes de ERK. 8 Conclusões. A viabilidade, proliferação e migração de hESC induzidas por veneno de L. obliqua ocorreram principalmente por proteção contra dano oxidativo e ativação da via dependente de ERK. Assim, esta é uma ferramenta farmacológica promissora para compreender os mecanismos subjacentes da deficiência de hESC em PGR. Background. Recurrent pregnancy loss (RPL) is associated with severe physical and psychological morbidity, for which there is no treatment options when excluded anatomic and genetic causes. The pathophysiology involves deficiency in proliferation and migration capacities of endometrial stromal cells (hESCs) impairing embryo implantation and development. Thus, finding new cytoprotective molecules able to stimulate hESCs proliferation could be interesting. Since animal venoms are rich source of bioactive molecules, in this work we aimed to characterize the cytoprotective effects of Lonomia obliqua venom on hESCs. Methodology. hESCs were isolated from fresh human endometrial biopsies and characterized according standard protocols. Then the effects of L. obliqua venomous secretions on cell viability, proliferation and migration were determined. Venom components involved in cell enhancing effects were also identified by classical chromatographic methods and proteomic analysis. Results. L. obliqua venom induced hESC proliferation, viability and migration in a dose-dependent manner both in the presence and serum deprivation conditions. By ion-exchange chromatography was obtained one fraction enriched in cytoprotective components devoid of hemotoxic effect. Venom proteomic analysis identified at least six protein classes with potential cytoprotective properties (hemolins, lipocalins, hemocyannins, antiviral proteins, antimicrobial peptides and protease inhibitors). The mechanism involved in cryoprotection seems to be related to downregulation of superoxide anion generation, increase in antioxidant enzymes, nitric oxide production and activation of ERK-dependent pathways of proliferation. Conclusions. L. obliqua venom-induced hESC viability, proliferation and migration occurred mainly by protection against oxidative damage and ERK-dependent pathway activation. 10 Thus, this is a promising pharmacological tool to understand underlying mechanisms of hESC deficiency in RPL.

Contact with Lonomia caterpillars can cause a hemorrhagic syndrome. In Brazil, Lonomia obliqua and Lonomia achelous are known to cause this venom-induced disease. In the Brazilian Amazon, descriptions of this kind of envenomation are scarce. Herein, we report a severe hemorrhagic syndrome caused by Lonomia envenomation in the Amazonas state, Western Brazilian Amazon. The patient showed signs of hemorrhage lasting 8 days and required Lonomia antivenom administration, which resulted in resolution of hemorrhagic syndrome. Thus, availability of Lonomia antivenom as well as early antivenom therapy administration should be addressed across remote areas in the Amazon.

Introduction: Lonomic accidents have become of great interest as they represent a public health problem in rural communities. These accidents are challenging for health personnel given their multiple associated complications, difficult diagnosis and therapeutic variants. Case presentation: This is the case of a 41-year-old male patient who had contact with a caterpillar of the genus Lonomia sp. He presented with symptoms of bleeding and subsequent multiple organ failure that resolved with the use of antilonomic serum. Discussion: The patient presented with symptoms that progressed to multiple organ failure and associated hemorrhagic syndrome due to the difficulties for diagnosis. He required therapeutic intervention in a primary care institution with subsequent need for treatment in a more complex center considering the deterioration and non-availability of the antilonomic serum. Conclusions: Based on in-hospital medical intervention strategies, the administration of the lonomic serum and the patient's follow-up through the system, it was possible to confirm the improvement of his health condition and discharge him. It is important to stress the knowledge of the health professionals who treat these cases in rural areas and the availability of the serum. RESUMEN Introducción. El accidente lonómico se ha convertido en un evento de gran interés, ya que supone una problemática de salud pública enfocada en las comunidades rurales y un reto para el personal de salud dadas las múltiples complicaciones, el difícil diagnóstico y las variantes terapéuticas. Presentación del caso. Paciente masculino de 41 años quien tuvo contacto con oruga del género Lonomia sp. y presentó síntomas de sangrado y posterior falla multiorgánica que se resolvió con el uso de suero antilonómico. Discusión. Se presenta un cuadro clínico que progresó a falla multiorgánica y síndrome hemorrágico asociado a dificultades en su diagnóstico y que requirió intervención terapéutica en primer nivel de urgencia con posterior necesidad de tratamiento en un centro de mayor complejidad por deterioro y no disponibilidad de suero antilonómico. Conclusiones. A partir de las estrategias de intervención médica intrahospitalaria, la administración del suero lonómico y el seguimiento del paciente a través del sistema, se pudo constatar la mejoría en el estado de salud y dar el alta médica. Es importante poner en tensión los conocimientos de los profesionales en salud que atienden estos casos en las zonas rurales y la disponibilidad del suero de tratamiento.

Los lepidópteros constituyen uno de los grupos de insectos más ampliamente distribuidos y reconocidos en el mundo, sus orugas presentan variedad de formas y colores casi infinitas, increíblemente atractivas, algunas tan hermosas como venenosas. Dentro de la familia Saturniidae encontramos al género Lonomia, cuyas orugas son de amplio interés médico en toda América del Sur por ser el agente etiológico del "lonomismo", una forma de envenenamiento causado por el contacto de las personas con las estructuras urticantes (espinas) que recubren el cuerpo larval. Estas espinas contienen en su interior una mezcla de compuestos tóxicos que actúan sobre diferentes componentes del sistema hemostático, causando no sólo problemas a nivel local, como dermatitis urticante, sino también un síndrome hemorrágico sistémico que puede llegar a ser fatal. En los últimos años, debido a su gravedad y al incremento en el número de casos, el lonomismo paso a ser considerado una problemática de salud emergente en la provincia de Misiones (única provincia del país donde se han notificado casos de lonomismo hasta la fecha). Teniendo en cuenta que la distribución así como también otros aspectos ecoepidemiológicos del género Lonomia son muy poco conocidos en Argentina, en este trabajo se muestra la distribución de accidentes con orugas de este género que fueron atendidos en el Hospital SAMIC de Puerto Iguazú (hospital de referencia para el atendimiento de los casos de lonomismo en la provincia de Misiones), así como también las plantas hospedadoras en donde se encontraban las orugas al momento del accidente. Para algunos sitios se incluye también el análisis granulométrico de muestras de suelo. De este modo se intenta brindar una aproximación a la distribución y requerimientos ecológicos de este género en Argentina. Fil: Casafús, Milena Gisela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina Fil: Melo Favalesso, Marília. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina Fil: Bittencourt Guimaraes, Ana Tereza. Universidade Estadual Do Oeste Do Pará; Brasil Fil: Peichoto, María Elisa. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina

Envenomation caused by human contact with the caterpillar Lonomia is characterized by deleterious effects on coagulation and patency of blood vessels. The cellular effects induced by Lonomia obliqua venom highlights its capacity to activate endothelial cells, leading to a proinflammatory phenotype. Having more knowledge about the mechanisms involved in envenomation may contribute to better treatment. We aimed to evaluate the effects of Lonomia obliqua caterpillar bristle extract (LOCBE) on vascular smooth muscle cells (VSMC). We observed that LOCBE induced VSMC migration, which was preceded by alterations in actin cytoskeleton dynamics and Focal Adhesion Kinase activation. LOCBE also induced Extracellular Signal-Regulated Kinase (ERK) phosphorylation in VSMC, and the inhibition of this pathway impaired cell proliferation. Stimulation of VSMC with LOCBE triggered reactive oxygen species (ROS) production through the activation of NADPH oxidase. The rapid increase in these ROS further induced mitochondrial ROS production, however only NADPH oxidase-derived ROS were involved in ERK activation in VSMC. We that demonstrated the chemotactic and proliferative effects of LOCBE on VSMC were dependent on ROS production, mainly through NADPH oxidase. Together, the data show that Lonomia obliqua venom can interact with and activate VSMC. These effects rely on ROS production, suggesting new potential targets for treatment against vascular damage during envenomation.

Patients envenomed by Lonomia sp caterpillars initially experience a mild burning pain, headache, nausea, vomiting, and skin and mucosal hemorrhages. Some patients can rapidly progress to a severe coagulopathy that presents as visceral or intracerebral hemorrhaging. We studied the hemostatic alterations that occurred in 14 patients who were envenomed by Lonomia obliqua in Southern Brazil and presented at the Hospital São Vicente de Paulo (Passo Fundo, RS), Brazil during the summers of 1993 and 1994 when Lonomia antivenom was not yet available for treatment. The patients were classified into to 4 clinical groups: 0 (two patients), I (eight patients), II (two patients), and III (two patients). The patients were admitted to the hospital between 4 hours and five days after contact with the caterpillars. In this study, the coagulation parameters of the patients were followed up for up to 172 hours after the accidents. The patients received no treatment with the exceptions of two patients who received blood transfusions and antifibrinolytic treatment. The observed abnormalities related to blood coagulation and fibrinolytic factors were similar regardless of the severity of the bleeding symptoms. These findings suggest that alterations in hemostatic parameters without thrombocytopenia are not predictors of the seriousness of such accidents. Thus, consumptive disorder and reactive fibrinolysis are not proportional to mild coagulopathy. Furthermore, these patients recovered. The hemostatic parameters of most of the patients normalized between 96 and 120 h after the accident.

As queimaduras causadas pelo contato com lagartas do gênero Lonomia, foi descrita pela primeira no Brasil em 1986. A partir de 1989, estes acidentes assumem dimensões epidêmicas nos Estados de Santa Catariana e Rio Grande do Sul. Nos últimos anos, nota-se o aumento dos casos, verificando-se a tendência de expansão para outras áreas do país. Assim, o objetivo deste trabalho é efetuar o mapeamento dos acidentes provocados pela lagarta do gênero Lonomia, no Brasil, no período de 2000 a 2007, utilizando sistemas de informação geográfica. Os resultados mostram que a Região Sul do país apresenta a maior freqüência de acidentes com este tipo de taturana. Contudo nota-se que a ocorrência deste tipo de agravo está aumentando, pois acidentes estão ocorrendo nas outras regiões do país. Sabe-se que os acidentes nos Estados de Santa Catarina, Rio Grande do Sul, Paraná e São Paulo são causados principalmente pela Lonomia obliqua, Periga circunstans, Periga falcata e Periga gueneei. Nos Estados da Bahia e Espírito Santo os agravos são acometidos pelas espécies Lonomia obliqua e Periga insidiosa. Já nos Estados do Pará, Mato Grosso e Goiás são encontradas a Lonomia obliqua, Lonomia descimoni, Lonomia achelous, Periga insidiosa, Periga angulosa, Periga cynira, Periga gueneei.

In South America, accidental contact with Lepidoptera larvae can produce a diversity of reactions that vary from dermatological problems to severe hemorrhagic syndromes, such as those caused by contact with caterpillars of the genus Lonomia (Saturniidae). Lonomia venom can alter the hemostatic system and lead to renal failure, internal and brain bleeding, and in severe cases, death. The only specific treatment available for these envenomations is the Lonomia Antivenom (LAV) produced by the Butantan Institute, in Brazil, using an extract of Lonomia obliqua scoli as the antigen. LAV has been used to treat exposure to other Lonomia species across South America. However, no experimental studies have been performed to test the efficacy of LAV in neutralizing the venom of species other than L. obliqua found in Southern Brazil. In this study, we tested the effectiveness of LAV in reversing the hemostatic disturbances induced by injecting Lonomia casanarensis (Lca) and Lonomia orientoandensis (Lor) scolus extracts into rats and compared the effects to the case of L. obliqua (Lob) scolus extract-induced envenomation. Lca and Lor caterpillars were collected in Colombia, and some of them were reared to adults for identification. The Minimum Defibrinating Doses (MDD) of Lca and Lor were estimated. Rats were injected (i.d.) with a dose of 3 MDD per rat of each scolus extract and treated (i.v.) with 1.5 mL of LAV or 1.5 mL of saline. Twenty-four hours after the treatment, the fibrinogen levels and platelet counts had recovered to the hemostatic levels in the groups treated with LAV. The groups treated with the saline solution had fibrinogen levels and platelet counts at non-hemostatic levels. Thromboelastometric analyses confirmed these results. In conclusion, the results showed that LAV is effective at neutralizing the envenomation induced by Lca and Lor spine extracts in rats and restoring hemostasis., Author summary A specific antivenom therapy is recommended for treating envenomation caused by venomous animals, such as snakes, spiders, scorpions, and Lonomia caterpillars. Studies with snake bites have shown that antivenoms are effective for treating the envenomation caused by snakes of the same genus, even when the antigen composition used to generate the antivenom did not include the specific venom. The Lonomia antivenom produced by the Butantan Institute to treat envenomations caused by contact with Lonomia caterpillars only uses the extract of Lonomia obliqua scoli as the antigen. However, there are reports of other species of Lonomia in South America that demonstrate biological activities that are different from those observed in response to L. obliqua venom, but which cause similar symptoms in human envenomation. No information is available regarding the neutralizing capacity of the Lonomia antivenom in these other species. This study showed that the Lonomia antivenom efficiently reversed the hemostatic disorders induced in rats by injection of extracts of the scoli of L. casanarensis and L. orientoandensis from Colombia. These results support the possibility of using this antivenom for treating envenomations caused by other Lonomia species in humans.

Envenomation caused by Lonomia obliqua is a public health hazard in Southern Brazil. Envenomed victims present severe hemorrhagic syndrome that can progress to intracranial hemorrhage and death. To understand the mechanisms that lead to hemorrhage, we investigated the platelet dysfunction and blood coagulation disturbances following experimental envenomation in rats. L. obliqua bristle extract was injected (s.c.) and blood collected at different times post-venom administration for determination of platelet response and analysis of blood coagulation. Rats presented hypofibrinogenemia and platelet hypoaggregation in platelet rich plasma (PRP). After addition of exogenous fibrinogen to PRP, platelet hypoaggregation was not corrected. Interestingly, normoaggregation was observed when platelets were separated from plasma. In addition, incubation of plasma from envenomed rats inhibits aggregation response of normal washed platelets. These results indicate that an aggregation inhibitor is generated in plasma during envenomation. Moreover, rats presented an increase in nitric oxide plasmatic levels which coincided with maximum inhibition in platelet aggregation. Animals also showed blood incoagulability and a significant increase in thrombin, plasmin and urokinase plasmatic activities. Despite this intravascular thrombin generation, only a slight decrease in platelet numbers was detected. Certainly, the platelet hypoaggregation and blood incoagulability described herein contribute to systemic bleeding observed in patients.

Lonomia obliqua (Walker, 1855) es una mariposa nocturna de la familia Saturniidae, ampliamente distribuida en selvas tropicales de Sudamérica. Su larva (oruga) se caracteriza por poseer espículas ramificadas puntiagudas a lo largo de su cuerpo, que contienen una mezcla compleja de moléculas tóxicas en su interior. Cuando las espículas contactan con la piel de las personas, las toxinas ingresan pasivamente a través de la lesión, generando un envenenamiento caracterizado por manifestaciones no solo locales sino también sistémicas (fundamentalmente manifestaciones hemorrágicas). Debido al elevado número de casos que se produjeron en Brasil en las últimas décadas, el Instituto Butantan ha producido un antiveneno capaz de neutralizar los efectos deletéreos de los accidentes por contacto con L. obliqua. En Argentina, los accidentes por Lonomia son poco frecuentes y se limitan a la provincia de Misiones. Teniendo en cuenta que a la fecha no hay en la literatura descripciones de casos clínicos ocurridos en el país con tratamiento específico (antiveneno), el propósito del presente trabajo es comunicar seis casos de accidentes por contacto con orugas Lonomia que fueron atendidos en el Hospital SAMIC de Puerto Iguazú (Misiones, Argentina) durante el año 2014, y que fueron tratados con el suero antilonómico producido en Brasil. Se destaca la evolución rápida y favorable de todos los pacientes por lo que se recomienda el uso de este antiveneno para tratar los casos de erucismo por Lonomia en la Argentina. Lonomia obliqua (Walker, 1855) is a moth from the family Saturniidae, widely distributed in tropical rainforests of South America. In its larval stage (caterpillar) it is characterized by bristles that cover the animal's body. These structures are hard and branched spiny evaginations of the cuticle, underneath which a complex mixture of toxic molecules is stored. When spicules are brought into contact with the skin of people, toxins enter passively through the injury, causing not only local but also systemic poisoning (primarily hemorrhagic manifestations). When the whole animal is accidentally crushed, the insect's chitinous bristles are broken and the venomous secretions penetrate the human skin, reaching the blood circulation. Due to the numerous registered cases of erucism in Southern Brazil, the Butantan Institute has produced an antivenom able to neutralize the deleterious effects produced by contact with L. obliqua caterpillar bristles. In Argentina, these kinds of accidents are rare and restricted to the province of Misiones. Taking into account that to date there is no report in this country about clinical cases submitted to a specific treatment (antivenom), our aim is to communicate here six cases of Lonomia caterpillar-induced bleeding syndrome that were treated in the Hospital SAMIC of Puerto Iguazú (Misiones, Argentina) during 2014 with the antilonomic serum produced in Brazil. It is worthy to note that all patients evolved favorably within the first few hours, and for this reason, the use of this antivenom is recommended to treat the cases of Lonomia erucism in Argentina. Fil: Sanchez, Matias Nicolas. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Mignone Chagas, Mariana. Hospital SAMIC Marta T. Schwarz; Argentina Fil: Casertano, Sergio A.. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina Fil: Cavagnaro, Luis E.. Hospital SAMIC Marta T. Schwarz; Argentina Fil: Peichoto, María Elisa. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Caterpillars are the wormlike, larval forms of butterflies and moths of the insect order Lepidoptera. Next to flies, lepidopterans are the most abundant arthropods with more than 165,000 species worldwide, and with most species posing no human threats. However, caterpillar species from approximately 12 families of moths or butterflies worldwide can inflict serious human injuries ranging from urticarial dermatitis and atopic asthma to osteochondritis, consumption coagulopathy, renal failure, and intracerebral hemorrhage. Unlike bees and wasps, envenoming or stinging caterpillars do not possess stingers or modified ovipositors attached to venom glands, but instead bear highly specialized external nettling or urticating hairs and breakaway spines or setae to defend against attacks by predators and enemies. Since the 1970s, there have been increasing reports of mass dermatolgic, pulmonary, and systemic reactions following caterpillar encounters throughout the world.

Skin contact with Lonomia caterpillar bristles causes a consumptive coagulopathy. From a cDNA library we cloned and expressed a prothrombin activator (rLopap) in active form, and from the bristles extract we characterized a FX activator (Losac). Several clones were sequenced and analyzed by expressed sequence tags. A database of about 1,270 sequences was constructed and deposited in NCBI. Both the native protein from the venom (Lopap) and the recombinant form (r-Lopap) promoted prothrombin hydrolysis, generating prethrombin-2, F1.2 and thrombin. Losac is a single-chain (43 kDa) protein that cleaves the FX heavy chain producing FXaα. In HUVECs rLopap and Losac are able to modulate cell survival by preventing apoptosis. rLopap increases NO and PGI2 concentration and Losac induces t-PA expression. Finally, to identify the venom proteins related to human envenomation, a 2D electrophoresis map is being performed as an attempt to find the major toxins recognized by the anti-lonomia venom.

Relata-se o caso de um homem de 44 anos, natural do Rio de Janeiro, residente no município de Teresópolis (RJ), vítima de um provável acidente por lagarta do gênero Lonomia, que evoluiu com quadro caracterizado por anemia hemolítica, plaquetopenia e insuficiência renal aguda. O diagnóstico de erucismo por Lonomia foi estabelecido a partir da anamnese e das manifestações clínicas e laboratoriais. O esquema terapêutico, baseado em hemodiálise e hemotransfusão, resultou em excelente resposta clínica. São discutidos os aspectos clínicos e fisiopatológicos do erucismo por Lonomia.

To the editorErucism is the name given to injuries caused by mothlarvae in humans. The lesions are provoked by caterpillarbristles filled with toxins that penetrate the skin [1-4]. Thebristles are hollow and when they enter the skin and break,toxins that contain thermolabile proteins, proteolytic en-zymes and histamine are released [2]. The shape of bristlesindicates the families of caterpillars mainly associated withinjuries: Megalopygidae (fine setae throughout the body)and Saturniidae (setae in smallpinetreeformat,seeFigure 1) [3]. The toxins cause immediate severe pain,erythema, edema and immediate lymphangitis (Figure 1).In later stages, there may be vesicles, bullae, erosions, pe-techiae, superficial skin necrosis, and ulcerations [4]. Somegenera (Lonomia, Periga) can cause severe hemorrhagicsyndromes, but most manifestations are limited to excruci-ating pain and mild to moderate local inflammation [1-4].Treatment for such injuries is based on cold watercompresses and oral analgesics (dipyrone is the rule, butthe use of potent analgesics, such as tramadol hydro-chloride may be required). When painkillers do notcontrol the pain, nerve anesthetic blockade (lidocaine4.0 mL for adults) may be employed [1-4]. Based on ourpast experience, we suggest using serial application oftopical commercial anesthetics with 0.25% lidocaine and0.25% prilocaine in order to greatly decrease or eliminatethe pain, these drugs take effect in about half an hourand last for several hours [1,4]. They are easy to apply,does not interfere with the approach adopted for thiskind of accident, and it is especially useful for childrenand patients whose lesion sites do not allow blockades.

The number of accidents caused by injection of the venom of Lonomia obliqua caterpillars in Southern Brazil has increased in the last years. Even though this kind of envenomation has an important social and medical impact, nothing is known about the cellular structures responsible for the production and secretion of this venom. Here we identify and analyse morphological structures possibly responsible for the production and secretion of the active principles of the venom, as well as the histological relationship of these structures with the urticating spines of L. obliqua. Detailed microscopic observations showed that: (a) L. obliqua has a complex tegument, with several cuticular specializations, (b) there are no pores along the tegument neither in the spines and (c) the spines bear a hollow canal—where the venom is deposited—and an area that can be easily broken when touched, releasing the venom. Histological and histochemical techniques revealed that: (a) there is no single gland cell that produces the venom, (b) a secretory epithelium, composed of cells containing vesicles that increase in size and number as they reach the apical region, underlies the tegument and the spines and is responsible for secretion of the venomous substances and (c) the venom is deposited in the subcuticular space and at the tips of the spines.

The second new species of the genus Moreiria is described from Brazil (São Paulo, Santa Catarina). The male of Moreiria maura Townsend, 1932 is recognized and a new definition for the genus is presented.