The aim of this study is to investigate the relationship between severity of envenomation and hematological parameter by detectig initial mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in pediatric patients presenting with a scorpion sting.

Scorpion stings are common emergency events in many parts of the world. It is common in tropical and subtropical regions. In our locality, Upper Egypt, scorpions still represent and a life hazard, especially to children .The clinical manifestations of scorpionism are due to complex interactions between sympathetic and parasympathetic stimulation.This leads to increased release of neurotransmitters and mediators, resulting in a cascade of pathological events, involving the nervous system, the cardiovascular and the respiratory system, eventually leading to death.Scorpionism results in hormonal and biochemical changes with significant release of catecholamines, increased angiotensin II and inhibition of insulin secretion .The symptoms and signs of envenomation are usually more severe in children, especially younger ones. Local pain represent 66 to 90 percent of stings which is practically immediate, of varying intensity ranging from mild to very intense. It is characterized by tingling, burning, or stinging. Regardless of the severity of envenoming, pain and paresthesia may persist at the site or at the affected limb for several days .Systemic effects become apparent in 10 to 33 percent of patients.After envenomation, symptoms may begin immediately and typically progress to maximum severity within 5 hours. The clinical effects of stings are characterized, cardiovascular, neurological and gastrointestinal effects .Cardiovascular effects are atrial tachycardia, ventricular extrasystoles, T-wave inversion, ST-T wave changes, bundle-branch block. Catecholamine-induced myocarditis and myocardial ischemia results in pulmonary edema and cardiogenic shock.Cardiovascular effects are atrial tachycardia, ventricular extrasystoles, T-wave inversion, ST-T wave changes, bundle-branch block. Catecholamine-induced myocarditis and myocardial ischemia results in pulmonary edema and cardiogenic shock..Gastrointestinal effects: are vomiting, abdominal pain and diarrhea. Also acute pancreatitis has been reported.Cardiovascular toxic effects and acute pulmonary edema are the most important complications of scorpion stings and the most frequent cause of death in the first 24 hours after the sting .Gastrointestinal effects: are vomiting, abdominal pain and diarrhea. Also acute pancreatitis has been reported.Cardiovascular toxic effects and acute pulmonary edema are the most important complications of scorpion stings and the most frequent cause of death in the first 24 hours after the sting .

Inclusion Criteria:

• a) Patients presented with scorpion sting

Exclusion Criteria:

• All other envenomation or intoxications

study on children stung by scorpion