eMedicine Specialties > Emergency Medicine > Toxicology
Toxicity, Shellfish: Differential Diagnoses & Workup
Updated: Oct 29, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
| CBRNE - Botulism | Toxicity, Scombroid |
| Gastroenteritis | Toxicity, Tetrodotoxin |
| Toxicity, Ciguatera | |
| Toxicity, Organophosphate and Carbamate | |
| Toxicity, Phenytoin |
Workup
Laboratory Studies
- Direct human serum assays for shellfish toxins are not yet available to clinicians. Research in this area is ongoing, and a reliable assay for several of these specific toxins should be available soon.
- Saxitoxin can be assayed by using a mouse bioassay, ELISA, and high-performance liquid chromatography (HPLC). Brevetoxin can be assayed by using a mouse bioassay, ELISA, and antibody radioimmunoassay (RIA). Liquid chromatography, mass spectrometry, and ELISA techniques have been developed for domoic acid.
- A new assay was used to quantify saxitoxin and neosaxitoxin in human urine samples, with results suggesting that few false-positive outcomes would occur when attempting to identify people exposed to these toxins.5
More on Toxicity, Shellfish |
| Overview: Toxicity, Shellfish |
Differential Diagnoses & Workup: Toxicity, Shellfish |
| Treatment & Medication: Toxicity, Shellfish |
| Follow-up: Toxicity, Shellfish |
| References |
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References
Burgess V, Shaw G. Pectenotoxins--an issue for public health: a review of their comparative toxicology and metabolism. Environ Int. Oct 2001;27(4):275-83. [Medline].
Lefebvre KA, Robertson A. Domoic acid and human exposure risks: A review. Toxicon. Jun 6 2009;[Medline].
Centers for Disease Control and Prevention. Update: Neurologic illness associated with eating Florida pufferfish, 2002. MMWR Morb Mortal Wkly Rep. May 17 2002;51(19):414-6. [Medline].
Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE. 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila). Dec 2008;46(10):927-1057. [Medline]. [Full Text].
Johnson RC, Zhou Y, Statler K, Thomas J, Cox F, Hall S, et al. Quantification of saxitoxin and neosaxitoxin in human urine utilizing isotope dilution tandem mass spectrometry. J Anal Toxicol. Jan-Feb 2009;33(1):8-14. [Medline].
Nicholson BC, Shaw GR, Morrall J, Senogles PJ, Woods TA, Papageorgiou J, et al. Chlorination for degrading saxitoxins (paralytic shellfish poisons) in water. Environ Technol. Nov 2003;24(11):1341-8. [Medline].
Ahmed FE. Seafood safety. Committee on Evaluation of the Safety of Fishery Products. Food & Nutrition Board, Institute of Medicine. National Academy Press; 1991.
Chandrasekaran A, Ponnambalam G, Kaur C. Domoic acid-induced neurotoxicity in the hippocampus of adult rats. Neurotox Res. 2004;6(2):105-17. [Medline].
Economou V, Papadopoulou C, Brett M, Kansouzidou A, Charalabopoulos K, Filioussis G, et al. Diarrheic shellfish poisoning due to toxic mussel consumption: the first recorded outbreak in Greece. Food Addit Contam. Mar 2007;24(3):297-305. [Medline].
Gessner BD, Middaugh JP, Doucette GJ. Paralytic shellfish poisoning in Kodiak, Alaska. West J Med. Nov 1997;167(5):351-3. [Medline].
Jeffery B, Barlow T, Moizer K, Paul S, Boyle C. Amnesic shellfish poison. Food Chem Toxicol. Apr 2004;42(4):545-57. [Medline].
Kawatsu K, Hamano Y, Noguchi T. Production and characterization of a monoclonal antibody against domoic acid and its application to enzyme immunoassay. Toxicon. Nov 1999;37(11):1579-89. [Medline].
Poli MA, Musser SM, Dickey RW, Eilers PP, Hall S. Neurotoxic shellfish poisoning and brevetoxin metabolites: a case study from Florida. Toxicon. Jul 2000;38(7):981-93. [Medline].
Stommel EW, Watters MR. Marine Neurotoxins: Ingestible Toxins. Curr Treat Options Neurol. Mar 2004;6(2):105-114. [Medline].
Usleber E, Dietrich R, Burk C, Schneider E, Martlbauer E. Immunoassay methods for paralytic shellfish poisoning toxins. J AOAC Int. Sep-Oct 2001;84(5):1649-56. [Medline].
Vale P, Sampayo MA. Comparison between HPLC and a commercial immunoassay kit for detection of okadaic acid and esters in Portuguese bivalves. Toxicon. Nov 1999;37(11):1565-77. [Medline].
Van Dolah FM. Marine algal toxins: origins, health effects, and their increased occurrence. Environ Health Perspect. Mar 2000;108 Suppl 1:133-41. [Medline].
Further Reading
Keywords
paralytic shellfish poisoning, PSP, neurologic shellfish poisoning, NSP, diarrheal shellfish poisoning, DSP, amnestic shellfish poisoning, ASP, brevetoxin, brevotoxin, shellfish toxicity, shellfish poisoning, shellfish exposure, shellfish ingestion, hepatitis A, Norwalk virus, Vibrio parahaemolyticus, Vibrio vulnificus, toxic shellfish, saxitoxin, okadaic acid, domoic acid
Differential Diagnoses & Workup: Toxicity, Shellfish