Neurological Manifestations of Puffer Fish Poisoning and Its Outcome: Study of 83 Cases

Haque, M Azizul; Islam, Quazi Tarikul; Razzak, M.A.; Faiz, MA; Bari, MI

doi:10.3329/taj.v21i2.3790

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…In Japan, the fatality rate fell from 80% at the beginning of the last century, with more than 100 deaths per year, to about 6% in the 90 s [ 6 , 23 , 24 ] due to the improvement of early life-saving systems in emergency medicine. In other Asian countries, mortality rates between 2–22% were reported [ 10 , 25 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

2011

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Tetrodotoxin (TTX) is a powerful sodium channel blocker found in puffer fish and some marine animals. Cases of TTX poisoning most often result from puffer fish ingestion. Diagnosis is mainly from patient’s signs and symptoms or the detection of TTX in the leftover food. If leftover food is unavailable, the determination of TTX in the patient’s urine and/or plasma is essential to confirm the diagnosis. Although various methods for the determination of TTX have been published, most of them are for food tissue samples. Dealing with human urine and blood samples is much more challenging. Unlike in food, the amount of toxin in the urine and blood of a patient is generally extremely low; therefore a very sensitive method is required to detect it. In this regard, mass spectrometry (MS) methods are the best choice. Since TTX is a very polar compound, there will be lack of retention on conventional reverse-phase columns; use of ion pair reagent or hydrophilic interaction liquid chromatography (HILIC) can help solve this problem. The problem of ion suppression is another challenge in analyzing polar compound in biological samples. This review will discuss different MS methods and their pros and cons.

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Section: Introductionmentioning

confidence: 99%

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

2011

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“…In cases of poisoning from TTX consumption, the only treatment available to the patient is supportive care [28,35,[37][38][39]. Early diagnosis and supportive treatment of TTX poisoning can lead to favorable outcomes [40]. Therefore, it is very important for healthcare personnel to have sufficient knowledge about the clinical findings and complications of pufferfish (TTX) poisoning, so that the health professional can knowingly administer the supportive care.…”

Section: Tetrodotoxin Poisoning Symptomsmentioning

confidence: 99%

Assessment of Human Health Impacts from Invasive Pufferfish (Attacks, Poisonings and Fatalities) across the Eastern Mediterranean

Ulman,

Abd Rabou,

Al Mabruk

et al. 2024

Biology

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The silver-cheeked toadfish Lagocephalus sceleratus (Gmelin 1789), and to a lesser degree the orange spotted toadfish Torquigener hypselogeneion (Bleeker, 1852), pose threats to human health from physical attacks and poisonings in the Eastern Mediterranean Sea. This study reviewed human health-related impacts resulting from these pufferfish, compiling and assessing records from online sources, the peer-reviewed literature, medical records, personal interviews, and observations across the Eastern Mediterranean in the years 2004 to 2023. A total of 198 events impacting human health were documented: 28 records of physical attacks, at least 144 non-lethal poisoning episodes, and 27 human fatalities resulting from consumption. The majority of the reported incidences occurred in Syria, Türkiye, and Lebanon. Most physical attacks occurred in summer, while most poisoning events occurred during winter. The number of recorded incidents greatly increased after 2019, especially with regard to poisonings, yet whether this is related to greater media attention, or to increased fish abundance is unclear. This is the first comprehensive study to collate findings on attacks, poisonings and fatalities caused by these pufferfish in the Mediterranean Sea, and may help in improving national health policies. We urge the continuation of national campaigns to caution residents and tourists of these species’ high toxicities and potential aggressiveness.

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“…Moreover, there is currently no effective antidote for TTX that can be used in the treatment of intoxications [104]. However, recovery can be achieved with early diagnosis and supportive treatment [114]. If the victim does not die of respiratory failure within 24 h, the patient could recover without any disorders [110].…”

Section: Toxicity Of Ttx (In Human Experimental Animals and In Vitro)mentioning

confidence: 99%

An Updated Review of Tetrodotoxin and Its Peculiarities

et al. 2022

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Tetrodotoxin (TTX) is a crystalline, weakly basic, colorless organic substance and is one of the most potent marine toxins known. Although TTX was first isolated from pufferfish, it has been found in numerous other marine organisms and a few terrestrial species. Moreover, tetrodotoxication is still an important health problem today, as TTX has no known antidote. TTX poisonings were most commonly reported from Japan, Thailand, and China, but today the risk of TTX poisoning is spreading around the world. Recent studies have shown that TTX-containing fish are being found in other regions of the Pacific and in the Indian Ocean, as well as the Mediterranean Sea. This review aims to summarize pertinent information available to date on the structure, origin, distribution, mechanism of action of TTX and analytical methods used for the detection of TTX, as well as on TTX-containing organisms, symptoms of TTX poisoning, and incidence worldwide.

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Neurological Manifestations of Puffer Fish Poisoning and Its Outcome: Study of 83 Cases

Abstract: The study was carried out in Medicine and Pediatrics Department of Rajshahi Medical College Hospital, and Natore Sadar Hospital, both are located in the northern territory of Bangladesh. Period of study ranged from admission of patients till discharge.

Cited by 7 publications

References 6 publications

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

Assessment of Human Health Impacts from Invasive Pufferfish (Attacks, Poisonings and Fatalities) across the Eastern Mediterranean

An Updated Review of Tetrodotoxin and Its Peculiarities

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Neurological Manifestations of Puffer Fish Poisoning and Its Outcome: Study of 83 Cases

Abstract: The study was carried out in Medicine and Pediatrics Department of Rajshahi Medical College Hospital, and Natore Sadar Hospital, both are located in the northern territory of Bangladesh. Period of study ranged from admission of patients till discharge.

Cited by 7 publications

References 6 publications

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

Analytical Challenges: Determination of Tetrodotoxin in Human Urine and Plasma by LC-MS/MS

Assessment of Human Health Impacts from Invasive Pufferfish (Attacks, Poisonings and Fatalities) across the Eastern Mediterranean

An Updated Review of Tetrodotoxin and Its Peculiarities

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Product

Resources

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Neurological Manifestations of Puffer Fish Poisoning and Its Outcome: Study of 83 Cases