Puffer fish poisoning.

Abstract

1 Farhat SM, Schneider RC, Gray JM. Traumatic spinal extradural hematoma associated with cervical fractures in rheumatoid spondylitis. J Trauma 1973;13:591-9.2 Iplikcioglu AC, Bayar MA, Kokes F, et al. Magnetic resonance imaging in cervical trauma associated with ankylosing spondylitis: report of two cases. J Trauma 1994;36:412-3.

Clinical and epidemiological study of 27 poisonings caused by ingesting puffer fish (Tetrodontidae) in the states of Santa Catarina and Bahia, Brazil

“…TTX and STX act by blocking the extracellular-opening of the pore locus of voltage dependent sodium receptors, preventing depolarization and propagation of action potential in nerve cells. This action occurs in the peripheral motor, sensory and autonomic nerves 10,16 . TTX also acts by depressing the respiratory and vasomotor center of the encephalic trunk 4 .…”

“…1 and 2). A study in Brazil identified the components responsible for toxicity in Colomesus asellus, a freshwater species found in the Amazon region, to be saxitoxin and gonyautoxin 4,10 , toxins associated with PSP and not TTX 23 . Another study of Sphoeroides spengleri, a species found along the Atlantic coast, detected TTX and analogues (anhydro-TTX, Tetrodonic Acid and 4-epi-TTX): OLIVEIRA et al (2003) 22 showed that TTX levels in muscle, skin, and viscera from fish of the Sphoeroides genus are high and a risk to consumers, whereas levels in Lagocephalus genus are low and in theory present a lower degree of risk.…”

“…Patients with severe poisoning may enter a deep coma, have fixed and non-reactive pupils, apnea, and absence of encephalic trunk reflexes 4 . Victims who survive the acute phase of intoxication (the first 24 hours), usually recover without long term consequences 4,10,14 , but full recuperation may take days. Diagnosis is based on clinical history and a report of the consumption of puffer fish 26 .…”

“…TTX also acts by depressing the respiratory and vasomotor center of the encephalic trunk 4 . Death can occur due to muscle paralysis, respiratory depression, and circulatory failure 10 . There are reports of human death by bradycardia not responsive to any treatment (total atrioventricular blockage) 14 .…”

“…STX is responsible for paralytic shellfish poisoning (PSP) 10 which causes a range of symptoms similar to TTX envenomation 16 . Although not usually targeted, STXs have been incidentally found in numerous species of fish such as Colomesus asellus and some species of Sphoeroides.…”