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http://dx.doi.org/10.22537/jksct.18.1.42

Respiratory Failure following Tetramine poisoning after Ingestion of Sea Snail: A Case Report  

Lee, Joo Hwan (Department of Emergency Medicine, Daegu Fatima Hospital)
Park, Jin Wook (Department of Emergency Medicine, Daegu Fatima Hospital)
Hong, Seong Jun (Department of Emergency Medicine, Daegu Fatima Hospital)
Jeon, Jae-Cheon (Department of Emergency Medicine, Keimyung University Dongsan Medical Center)
Jin, Sang-Chan (Department of Emergency Medicine, Keimyung University Dongsan Medical Center)
Publication Information
Journal of The Korean Society of Clinical Toxicology / v.18, no.1, 2020 , pp. 42-46 More about this Journal
Abstract
Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5℃, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO2 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO3- 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.
Keywords
Tetramine; Respiratory failure; Gastropod; Sea snail; Poisoning;
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1 Anthoni U, Bohlin L, Larsen C, et al. Tetramine:occurrence in marine organisms and pharmacology. Toxicon 1989;27:707-16.   DOI
2 Jeon JK. Tetramine contents of buccinidae in the Korean waters. Korean J Fish Aquatic Sci 1990;23:61-2.
3 Kim JM, Yang YS, Jeong DS, et al. A case of tetramine intoxication from the neptunea. J Korean Neurol Assoc 2005;23:405-7.
4 Mustafa M, Yoshida T, Waheed Z, et al. Seafood poisoning symptom, treatment and prevention. Borneo J Mar Sci Aquac 2018;2:64-9.
5 Kim JH, Lee KJ, Suzuki T, et al. Identification of tetramine, a toxin in whelks, as the cause of a poisoning incident in Korea and the distribution of tetramine in fresh and boiled whelk (Neptunea intersculpta). J Food Prot 2009;72:1935-40.   DOI
6 Power AJ, Keegan BF, Nolan K. The seasonality and role of the neurotoxin tetramine in the salivary glands of the red whelk Neptunea antiqua (L.). Toxicon 2002;40:419-25.   DOI
7 Mok JS, Son KT, Lee TS, et al. Teramine contents of sea snails from the Korean coast. Korean J Fish Aquatic Sci 2007;40:63-7   DOI
8 Lin CC, Yang CC, Ger J, et al. Tetramethylammonium hydroxide poisoning. Clin Toxicol 2010;48:213-7.   DOI
9 Park SH, Park J, You KH, et al. Tetramethylammonium hydroxide poisoning during a pallet cleaning demonstration. J Occup Health 2013;55:120-4.   DOI
10 Wu CL, Su SB, Chen JL, et al. Tetramethylammonium ion causes respiratory failure related mortality in a rat model. Resuscitation 2012;83:119-24.   DOI
11 Hirsch NP. Neuromuscular junction in health and disease. Br J Anaesth 2007;99:132-8.   DOI
12 Kim WH, Kim JH, Kim EK, et al. Myasthenia gravis presenting as isolated respiratory failure: a case report. Korean J Intern Med 2010;25:101-4.   DOI
13 Chowdhury FR, Nazmul Ahasan HA, Mamunur Rashid AK, et al. Tetrodotoxin poisoning: a clinical analysis, role of neostigmine and short-term outcome of 53 cases. Singapore Med J 2007;48:830-3.
14 Kim SE, Lee JB, Jin YH, et al. Two cases of neurotoxin tetramine poisoning following ingestion of Buccinum striatissinum. J Korean Soc Clin Toxicol 2016;14:66-9.