Saxitoxin Exposure Confirmed by Human Urine and Food Analysis

Details

• Alternative Title:
  J Anal Toxicol
• Personal Author:
  Coleman, R.M. ; Ojeda-Torres, G. ; Bragg, W. ; Fearey, D. ; McKinney, P. ; Castrodale, L. ; Verbrugge, D. ; Stryker, K. ; DeHart, E. ; Cooper, M. ; Hamelin, E. ; Thomas, J. ; Johnson, R.C.
• Description:
  A case of an elderly female with suspected paralytic shellfish poisoning (PSP) is presented. The patient shared a meal of recreationally-harvested shellfish with her family and soon began to experience nausea and weakness. She was taken to the local emergency department and then transported to a larger hospital in Anchorage where she was admitted to the intensive care unit with respiratory depression and shock. Her condition improved, and she was discharged from the hospital 6 days later. No others who shared the meal reported symptoms of PSP. A clam remaining from the meal was collected and analyzed for paralytic shellfish toxins (PST) by the Alaska Department of Environmental Conservation Environmental Health Laboratory; the clam tested positive for saxitoxin (STX; 277 μg/100 g), neosaxitoxin (NEO; 309 μg/100 g), multiple gonyautoxins (GTX; 576-2490 μg/100 g), decarbamoyl congeners (7.52-11.3 μg/100 g) and C-toxins (10.8-221 μg/100 g) using high-pressure liquid chromatography with post-column oxidation (AOAC Method 2011.02). Urine from the patient was submitted to Centers for Disease Control for analysis of selected PSTs and creatinine. STX (64.0 μg/g-creatinine), NEO (60.0 μg/g-creatinine) and GTX1-4 (492-4780 μg/g-creatinine) were identified in the urine using online solid phase extraction with HPLC and tandem mass spectrometry. This was the first time GTX were identified in urine of a PSP case from Alaska, highlighting the need to include all STX congeners in testing to protect the public's health through a better understand of PST toxicity, monitoring and prevention of exposures.
• Subjects:
  Animals Bivalvia Chromatography, High Pressure Liquid Female Food Analysis Humans Saxitoxin Shellfish Poisoning Solid Phase Extraction Tandem Mass Spectrometry Urinalysis

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• Source:
  J Anal Toxicol. 42(7):e61-e64
• Pubmed ID:
  29800291
• Pubmed Central ID:
  PMC6943748
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  42
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0ab49a81df78af8bc9dcfa9b1c357793ca6a249bf8e7e9a512605b3f754dc45cc3809b30d46375424ff20f844528623ae13bf212fc8c6cb6d4c483d4fab02297
• Download URL:
  https://stacks.cdc.gov/view/cdc/84047/cdc_84047_DS1.pdf
• File Type:
  [PDF - 58.00 KB ]