Case diagnosis and characterization of suspected paralytic shellfish poisoning in Alaska

被引：23

作者：

Knaack, Jennifer S. ^{[1
,10
]}

Porter, Kimberly A. ^{[2
]}

Jacob, Justin T. ^{[3
]}

Sullivan, Kate ^{[4
]}

Forester, Matthew ^{[5
]}

Wang, Richard Y. ^{[1
]}

Trainer, Vera L. ^{[6
]}

Morton, Steve ^{[7
]}

Eckert, Ginny ^{[8
]}

McGahee, Ernest ^{[1
]}

Thomas, Jerry ^{[1
]}

McLaughlin, Joseph ^{[9
]}

Johnson, Rudolph C. ^{[1
]}

机构：

[1] Ctr Dis Control & Prevent, Emergency Response Branch, Div Sci Lab, Natl Ctr Environm Hlth, 4770 Buford Highway,MS F44, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Alaska Sect Epidemiol, 1600 Clifton Rd, Atlanta, GA 30333 USA

[3] Ctr Dis Control & Prevent, MC-100-44,POB 117, Oak Ridge, TN 37831 USA

[4] Univ Alaska Southeast, Fisheries Technol, 2600 7th Ave, Ketchikan, AK 99901 USA

[5] Alaska Dept Environm Conservat, Alaska Environm Hlth Lab, 5251 Dr Martin Luther King Jr Ave, Anchorage, AK 99507 USA

[6] NOAA, Marine Biotoxins Program, Northwest Fisheries Sci Ctr, Natl Marine Fisheries Serv, Seattle, WA 98112 USA

[7] NOAA, Natl Ctr Coastal Ocean Sci, Marine Biotoxins Program, 219 Ft Johnson Rd, Charleston, SC 29412 USA

[8] Univ Alaska Fairbanks, Sch Fisheries & Ocean Sci, 17701 Point Lena Loop Rd, Juneau, AK 99801 USA

[9] Alaska Dept Hlth & Social Serv, Sect Epidemiol, 3601 C St,Suite 540, Anchorage, AK 99503 USA

[10] Mercer Univ, Dept Pharmaceut Sci, 3001 Mercer Univ Dr,DV-114, Atlanta, GA 30341 USA

来源：

HARMFUL ALGAE | 2016年 / 57卷

关键词：

Alaska; High performance liquid chromatography; Mass spectrometry; Paralytic shellfish poisoning; Paralytic shellfish toxin; Saxitoxin; POSTMORTEM ANALYSIS; SODIUM-CHANNELS; HUMAN URINE; SAXITOXIN; TOXINS; TETRODOTOXIN; SAMPLES; SAFETY; HEALTH; NERVE;

D O I：

10.1016/j.hal.2016.03.006

中图分类号：

Q17 [水生生物学];

学科分类号：

071004 ;

摘要：

Clinical cases of paralytic shellfish poisoning (PSP) are common in Alaska, and result from human consumption of shellfish contaminated with saxitoxin (STX) and its analogues. Diagnosis of PSP is presumptive and based on recent ingestion of shellfish and presence of manifestations consistent with symptoms of PSP; diagnosis is confirmed by detection of paralytic shellfish toxins in a clinical specimen or food sample. A clinical diagnostic analytical method using high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) was used to evaluate the diagnosis of saxitoxin-induced PSP (STX-PSP) in 11 Alaskan patients using urine specimens collected between June 2010 and November 2011. Concentrations of urinary STX were corrected for creatinine concentrations to account for dilution or concentration of urine from water intake or restriction, respectively. Of the 11 patients with suspected PSP, four patients were confirmed to have STX-PSP by urine testing (24-364 ng STX/g creatinine). Five patients had clinical manifestations of PSP though no STX was detected in their urine. Two patients were ruled out for STX-PSP based on non-detected urinary STX and the absence of clinical findings. Results revealed that dysphagia and dysarthria may be stronger indicators of PSP than paresthesia and nausea, which are commonly used to clinically diagnose patients with PSP. PSP can also occur from exposure to a number of STX congeners, such as gonyautoxins, however their presence in urine was not assessed in this investigation. In addition, meal remnants obtained from six presumptive PSP cases were analyzed using the Association of Official Analytical Chemists' mouse bioassay. All six samples tested positive for PSP toxins. In the future, the clinical diagnostic method can be used in conjunction with the mouse bioassay or HPLC-MS/MS to assess the extent of STX-PSP in Alaska where it has been suggested that PSP is underreported. Published by Elsevier B.V.

引用

页码：45 / 50

页数：6

共 33 条

[1] TOXIC RED TIDES AND HARMFUL ALGAL BLOOMS - A PRACTICAL CHALLENGE IN COASTAL OCEANOGRAPHY [J].