Clinical characteristics of patients with Haff disease after eating crayfish

Abstract

BACKGROUND: The study aimed to explore the clinical presentations, laboratory findings, treatments and prognosis of patients with Haff disease after eating crayfi sh. METHODS: Sixteen patients with Haff disease after eating crayfish were admitted to the Emergency Department of Beijing Chao-yang Hospital between June 2013 and August 2017. Clinical data was retrospectively analyzed. RESULTS: Alcohol consumption and exercise were found to be most commonly associated with the onset of rhabdomyolysis after consuming crayfi sh. Most patients were young adults and the symptoms mostly occurred within 24 hours of consumption of crayfi sh. Clinical symptoms included myalgia (100%), fatigue (87.5%), nausea (43.8%), dizziness (62.5%), chest distress (37.5%) and fever (18.8%). Also found after laboratory testing was elevations in the levels of creatine kinase (11,376±5,535 U/L), myoglobin (350±158 ng/mL), lactate dehydrogenase (6,539±3,180 U/L), alanine transaminase (174±71 U/L) and aspartate aminase (348±100 U/L). The incidence of renal dysfunction was low (6.25%), and all 16 patients had a good prognosis. CONCLUSION: Patients with Haff disease exhibited typical symptoms after consuming crayfish, and laboratory findings gave highly accurate diagnostic results. The development of rhabdomyolysis was considered to be associated with alcohol consumption and exercise, but further studies are needed to demonstrate its relationship with crayfi sh consumption. Compared with other causes of rhabdomyolysis, rhabdomyolysis after crayfi sh consumption has fewer complications and better prognosis.

Ionophore Toxin Maduramicin Produces Haff Disease-Like Rhabdomyolysis in a Mouse Model

“…ALT, AST, Mb, and LDH were also abnormally elevated in more than 80% of patients [23]. In severe cases, acute renal failure occurs, leading to elevated BUN indexes [23]. In this study, it was found that the indexes of CK, ALT, AST, LDH, and BUN in mice treated with 3.5 mg•kg −1 and 7 mg•kg −1 of maduramicin were significantly increased in a dose-dependent manner.…”

“…In general, serum CK of patients shows a sharp increase, which is more than five times higher than the normal level [44]. ALT, AST, Mb, and LDH were also abnormally elevated in more than 80% of patients [23]. In severe cases, acute renal failure occurs, leading to elevated BUN indexes [23].…”

Haff disease – are we threatened with another epidemic?

“…Jej przebieg może być łagodny (subkliniczny), z bezobjawowym wzrostem stężenia CK, lub może powodować zagrażające życiu powikłania, takie jak: AKI, martwica dużych grup mięśniowych, zespół rozsianego wykrzepiania wewnątrznaczyniowego (disseminated intravascular coagulation -DIC) [13]. W przypadku choroby Haff spektrum objawów oraz powikłań może być bardzo szerokie, rokowanie jest jednak w zdecydowanej większości dobre [10,14,15]. Opisano mimo to przypadki ciężkiego przebiegu choroby, które wymagały stosowania leczenia nerkozastępczego [5], a nawet doprowadziły do zgonu chorych w przebiegu niewydolności wielonarządowej [7,16].…”

“…Opisywany chory podawał w wywiadzie poprzedzającym wystąpienie objawów ciężką fizyczną pracę przy zbyt małej podaży płynów. Niektóre badania sugerują, że spożywanie alkoholu, intensywny wysiłek fizyczny czy spożywanie wątrób raków mogą zwiększać ryzyko rozwoju rabdomiolizy po spożyciu ryb lub skorupiaków [14,19]. Ponadto zwiększona ilość spożywanych ryb/skorupiaków jest wprost proporcjonalna do zwiększonego ryzyka rozwoju rabdomiolizy [19].…”