Saxitoxin Exposure Confirmed by Human Urine and Food Analysis

Abstract

A case of an elderly female with suspected paralytic shellfish poisoning (PSP) is presented. The patient shared a meal of recreationally-harvested shellfish with her family and soon began to experience nausea and weakness. She was taken to the local emergency department and then transported to a larger hospital in Anchorage where she was admitted to the intensive care unit with respiratory depression and shock. Her condition improved, and she was discharged from the hospital 6 days later. No others who shared the meal reported symptoms of PSP. A clam remaining from the meal was collected and analyzed for paralytic shellfish toxins (PST) by the Alaska Department of Environmental Conservation Environmental Health Laboratory; the clam tested positive for saxitoxin (STX; 277 μg/100 g), neosaxitoxin (NEO; 309 μg/100 g), multiple gonyautoxins (GTX; 576-2490 μg/100 g), decarbamoyl congeners (7.52-11.3 μg/100 g) and C-toxins (10.8-221 μg/100 g) using high-pressure liquid chromatography with post-column oxidation (AOAC Method 2011.02). Urine from the patient was submitted to Centers for Disease Control for analysis of selected PSTs and creatinine. STX (64.0 μg/g-creatinine), NEO (60.0 μg/g-creatinine) and GTX1-4 (492-4780 μg/g-creatinine) were identified in the urine using online solid phase extraction with HPLC and tandem mass spectrometry. This was the first time GTX were identified in urine of a PSP case from Alaska, highlighting the need to include all STX congeners in testing to protect the public's health through a better understand of PST toxicity, monitoring and prevention of exposures.

Electrochemical Biochip Assays Based on Anti-idiotypic Antibodies for Rapid and Automated On-Site Detection of Low Molecular Weight Toxins

“…Moreover, the diagnosis of STX intoxications in patients with suspected PSP was confirmed by detecting STX in urine (Knaack et al, 2016). Recently, Coleman et al (2018) reported a non-fatal case with an urinary toxin profile dominated by GTX-1/-4 and GTX-2/-3. The urine specimen contained 433 ng/mL GTX-2/-3 (44.8%) and only 15 ng/mL STX (1.7%) demonstrating the necessity for assays exhibiting broad specificity to all PSP toxins.…”

A theoretical estimation of exposure to shellfish toxins of different population groups in Bulgaria

“…Among them, consumption of contaminated shellfish is most commonly reported [18][19][20][21] . The symptoms of intoxication with marine biotoxins vary from diarrhea, nausea, abdominal pain 17 , confusion, disorientation, seizures, to respiratory depression and shock 23 , and very rarely death 24 . Based on the available human data on acute toxicity of marine biotoxins, the CONTAM Panel established ARfDs for them (Table 2).…”

Influence of biochar on the removal of Microcystin-LR and Saxitoxin from aqueous solutions

“…MCLR and STX were chosen as congeners of cyanobacteria for this study. MCLR is one of the most significant algae toxins in the United States due to its potent toxicity 52 , 53 , while STX is the most common and toxic congener of Paralytic Shellfish toxins (PSTs) 54 . It is important to highlight the difference in the physicochemical characteristics of MCLR and STX, reported in Table 1 and Fig.…”