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Palytoxin
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Jiri Patocka, Qinghua Wu, Kamil Kuca
PLTX, found in marine fish, has been associated with rhabdomyolysis [59]. The consumption of several species of cooked fish has caused Haff disease outbreaks worldwide. The bioaccumulation of a new heat-stable toxin in seafood, similar to PLTX, but primarily myotoxic and not neurotoxic, is suspected for causing Haff disease. Haff disease is a syndrome of myalgia and rhabdomyolysis that occurs after consuming cooked seafood. Over 1,000 cases of Haff disease were initially described in Eastern and North Europe during and following the ingestion of several species of cooked freshwater fish. More recent case reports followed consumption of cooked freshwater pomfret and boiled crayfish in China, and cooked or raw boxfish in Japan. There were 29 case reports of Haff disease in the United States with most following consumption of buffalo fish, crayfish, or Atlantic salmon [60].
Haff disease associated with consumption of buffalofish (Ictiobus spp.) in the United States, 2010–2020, with confirmation of the causative species
Published in Clinical Toxicology, 2022
Jonathan R. Deeds, Robert A. Literman, Sara M. Handy, Karl C. Klontz, Karen A. Swajian, Ronald A. Benner, Henry L. Bart
Detailed here are 10 cases and/or outbreaks of buffalofish-associated Haff disease involving 24 individuals that occurred in the United States between 2010 and 2020 that were investigated by the FDA. Eight of these events have not been reported previously in the literature. Both gross and clinical laboratory symptomology for these cases were consistent with those from previously reported cases of Haff disease. In addition to the cases described here, three instances of Haff disease were described in the literature during this period in the US that were not investigated by the FDA. One case involved a 42-year-old female in California, a second involved a 67-year-old female and her 40-year-old daughter in New York, and a third case involved one 29-year-old male also in New York [6,9,21]. All three instances had clinical features that were consistent with those described both here and in previous cases. The California case was associated with fried buffalofish consumption, while the two New York cases were associated with carp and a seafood buffet, respectively.
Outbreak of Haff disease caused by consumption of crayfish (Procambarus clarkii) in nanjing, China
Published in Clinical Toxicology, 2019
Baofu Guo, Guoxiang Xie, Xiaocheng Li, Yun Jiang, Di Jin, Yonglin Zhou, Yue Dai, Shiqi Zhen, Guiju Sun
Haff disease was first reported in the Baltic region in 1924 and defined as an illness with unexplained rhabdomyolysis when a person ingests certain types of fish before onset. In the following 9 years, similar outbreaks occurred seasonally in summer and fall along the coast of the “haff” (a shallow lagoon) [2]. From 1934 until 1984, other outbreaks resembling Haff disease were described in Sweden and the Soviet Union [3–6]. The first case reported in the United States occurred in 1984, and there were totally 29 cases of Haff disease reported in the US until 2014 [2,7–10]. Outbreaks of Haff disease have never been reported in Brazil until 2008, when 25 cases of Haff disease were identified [11]. Haff disease has seldomly been reported in China or other Asian countries, and outbreaks were less common [12]. The first six cases of Haff disease outbreak associated with eating crayfish (P. clarkii) were reported in Beijing in 2000, China. Subsequently, two outbreaks involving 54 cases in Lianzhou in 2009, Guangdong Province and 23 cases in Nanjing in 2010, Jiangsu Province were reported, respectively [13–15]. A crayfish-related Haff disease case complicated by multiple organ failure was reported in Shanghai in 2013 [16].
Haff disease complicated by acute lung injury after crayfish consumption: a case report
Published in Clinical Toxicology, 2018
The toxin that may be responsible for Haff disease has not yet been identified. All patients with Haff disease report a history of eating cooked fish or crayfish within 24 h before symptom onset [2–4]. The toxin appears to be heat-stable and accumulates in the implicated food. The United States Food and Drug Administration has assayed and excluded several known toxins in Haff disease-implicated food items including heavy metals, pesticides, herbicides, ciguatoxin, saxitoxin, brevetoxin, tetrodotoxin, palytoxin, domoic acid, and okadaic acid [3,5]. Currently, the diagnosis of Haff disease is mainly based on clinical manifestations, a history of freshwater fish consumption within 24 h before the onset of symptoms, and the levels of muscle necrosis markers, particularly myoglobin and CK [4]. In the present case, his condition was complicated by shortness of breath and decreased blood oxygen saturation as a result of exudates and atelectasis in a portion of the lower lobes, and a small amount of pleural effusion bilaterally. Although aspiration during vomiting was possible, the patient remained conscious during this time and there was no clinical suspicion of aspiration. Thus, we consider the patient to have had severe Haff disease complicated by acute lung injury after crayfish consumption.