Diaz James
Dr. Diaz is a Professor of Public Health and Preventive Medicine and Program Director, Environmental and Occupational Health Sciences, School of Public Health, Professor of Anesthesiology and Critical Care Medicine , School of Medicine, Louisiana State University Health Sciences Center in New Orleans, LA.
J La State Med Soc. 2015 Jan-Feb;167(1):6-10. Epub 2015 Feb 15.
Cases of Haff disease, a syndrome of severe myalgia and rhabdomyolysis, have been reported after eating cooked fish in Europe and the US. A retrospective review of US cases was conducted to identify seafood vectors, describe presenting manifestations, and compare the Haff disease toxidrome with other seafood-borne toxidromes. Internet search engines were queried to identify all US reports of Haff disease. The case definition of Haff disease required cooked seafood ingestion history within 24 hours and markedly elevated serum creatine kinase (CK) with CK-muscle/brain (MB) fraction < 5 percent. Twenty-six cases of Haff disease were reported in the US over 30 years, 1984-2014, with spring-summer occurrences. The mean age of cases was 54.8 years without gender difference. Most cases (58 percent) followed consumption of cooked buffalo fish, Ictiobus cyprinellus, (n = 15); other cases followed consumption of boiled crayfish in Louisiana (n = 9) and baked salmon in North Carolina (n = 2). California and Louisiana accounted for most cases (n = 18, p = 0.012). Following mean incubation periods of eight hours; the most common presenting manifestations included vomiting, myalgia, muscle rigidity, chest pain mimicking myocardial infarction, diaphoresis, dyspnea, and brown urine indicating myoglobinuria. Most patients recovered within 2-5 days. Haff disease may follow the consumption of freshwater buffalo fish, freshwater crayfish, and saltwater Atlantic salmon. The bioconcentration of a new, unidentified heat-stable, freshwater and/or brackish/saltwater algal myotoxin in seafood, similar to palytoxin, is suspected of causing Haff disease. Experimental animals fed toxic buffalo fish developed rhabdomyolysis with myoglobinuria.
在欧洲和美国，食用煮熟的鱼类后曾有过哈夫病病例报告，哈夫病是一种伴有严重肌痛和横纹肌溶解的综合征。开展了一项针对美国病例的回顾性研究，以确定海产品载体、描述临床表现，并将哈夫病中毒综合征与其他食源性海产品中毒综合征进行比较。通过互联网搜索引擎查询，以确定美国所有关于哈夫病的报告。哈夫病的病例定义要求在24小时内有食用煮熟海产品的病史，且血清肌酸激酶（CK）显著升高，同时CK-肌肉/脑（MB）分数<5%。1984年至2014年的30年间，美国共报告了26例哈夫病病例，发病时间为春夏季节。病例的平均年龄为54.8岁，无性别差异。大多数病例（58%）是在食用煮熟的水牛鱼（胭脂鱼）后发病（n = 15）；其他病例分别是在路易斯安那州食用煮小龙虾后发病（n = 9）以及在北卡罗来纳州食用烤三文鱼后发病（n = 2）。大多数病例发生在加利福尼亚州和路易斯安那州（n = 18，p = 0.012）。平均潜伏期为8小时；最常见的临床表现包括呕吐、肌痛、肌肉僵硬、类似心肌梗死的胸痛、出汗、呼吸困难以及提示肌红蛋白尿的棕色尿液。大多数患者在2至5天内康复。食用淡水水牛鱼、淡水小龙虾和咸水大西洋三文鱼后可能会引发哈夫病。怀疑海产品中一种新的、未明确的热稳定淡水和/或咸淡水/咸水藻类肌毒素的生物浓缩，类似于岩沙海葵毒素，是导致哈夫病的原因。用有毒水牛鱼喂食实验动物后出现了横纹肌溶解和肌红蛋白尿。
