Difference between revisions of "Tetrodotoxin"

(Created page with "==Background== *Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus) *Blocks neuronal action potential by blocking voltage-gated sod...")
 
 
(9 intermediate revisions by 5 users not shown)
Line 1: Line 1:
 
==Background==
 
==Background==
 
*Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
 
*Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
 +
**Heat-stable toxin not destroyed by washing, freezing or cooking
 
*Blocks neuronal action potential by blocking voltage-gated sodium channels
 
*Blocks neuronal action potential by blocking voltage-gated sodium channels
*Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity
+
*Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)
 +
[[File:Blue-ringed-octopus.jpeg|thumbnail]]
 +
 
 +
===Mechanism of Injury===
 +
*Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.
  
 
==Clinical Features==
 
==Clinical Features==
 
''Onset of symptoms usually within 30 min to 4 hours after eating pufferfish''
 
''Onset of symptoms usually within 30 min to 4 hours after eating pufferfish''
*Paresthesias
+
*Paresthesias, body numbness
 +
*Dysarthria, dysphagia
 
*[[Headache]]
 
*[[Headache]]
 
*[[Vomiting]], [[diarrhea]], [[abdominal pain]]
 
*[[Vomiting]], [[diarrhea]], [[abdominal pain]]
 
*Ascending paralysis
 
*Ascending paralysis
 
*Respiratory failure
 
*Respiratory failure
**Death
+
*Death
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 +
{{Marine envenomation DDX}}
  
 
==Evaluation==
 
==Evaluation==
Line 20: Line 27:
  
 
==Management==
 
==Management==
*Supportive care, intubate if concern for progressive paralysis
+
*Supportive care is mainstay of treatment
*Acetylcholinesterase inhibitors (e.g. [[neostigmine]])<ref>Tintanelli's</ref>
+
*May require intubation if concern for progressive paralysis
+
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])
 +
 
 
==Disposition==
 
==Disposition==
*Admit, may need ICU
+
*Admit (may need ICU)
 +
 
 +
==External Links==
 +
 
 +
 
 
==See Also==
 
==See Also==
 
*[[Marine toxins and envenomations]]
 
*[[Marine toxins and envenomations]]
==External Links==
 
  
 
==References==
 
==References==
 
<references/>
 
<references/>
 +
 +
==Video==
 +
{{#widget:YouTube|id=0DyrwwGQnlI}}
 +
 +
[[Category:Toxicology]]

Latest revision as of 06:42, 6 March 2019

Background

  • Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
    • Heat-stable toxin not destroyed by washing, freezing or cooking
  • Blocks neuronal action potential by blocking voltage-gated sodium channels
  • Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)
Blue-ringed-octopus.jpeg

Mechanism of Injury

  • Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.

Clinical Features

Onset of symptoms usually within 30 min to 4 hours after eating pufferfish

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
  • Evaluate for other treatable causes of symptoms

Management

Disposition

  • Admit (may need ICU)

External Links

See Also

References


Video