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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2001, Number 1

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Rev Biomed 2001; 12 (1)

Review of a litle-known disease: the ciguatera.

Arcila-Herrera H, Mendoza-Ayora J, González-Franco MF, Montero- Cervantes L, Castelo-Navarrete A

Language: Spanish
References: 51
Page: 27-34
PDF size: 40.84 Kb.


ABSTRACT

Ciguatera is a toxin-related disease caused by the ingestion of a variety of toxic fish living in tropical and subtropical areas. Humans are poisoned by eating fish intoxicated with toxins generated by the dinoflagellate Gambierdiscus toxicus associated with coral reefs. The first fish to show toxicity are the herbivorous forms and ciguatoxin becomes concentrated in large carnivores by way of the marine food web. Ciguatoxin, the major active principle in ciguatera, is believed to be a lipid soluble polyether compound, that increases intracelullar transportation of sodium ions. Several thousand cases have been reported over a 10-year period. Cases are increasing in number in the yucatecan peninsula of México. Ciguatera produces gastrointestinal characteristics, neurological and cardiovascular symptoms in this order of severity and time-related presentation in the patients. For most of the patients the earliest manifestations are diarrhea and vomiting. Fluid and electrolyte replacement is necesary to tre at hypotension caused by prolonged vomiting and diarrhea. Intravenous mannitol has been reported as a successful treatment for patients within 24 hours of the onset the clinical manifestations. Neurological symptoms involve mainly paresthesias. Amitriptyline has proven effective for paresthesias as has tocainida and cyrproheptadine for pruritus. The use of fluoxetine is successful in the treatment of chronic fatigue.


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