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犬类微囊藻毒素中毒的诊断:临床病理指征、病理特征以及尸检和生前样本中的分析检测。

Diagnosing Microcystin Intoxication of Canines: Clinicopathological Indications, Pathological Characteristics, and Analytical Detection in Postmortem and Antemortem Samples.

机构信息

GreenWater Laboratories, Palatka, FL 32177, USA.

Animal Care Cancer Clinic, Stuart, FL 34994, USA.

出版信息

Toxins (Basel). 2019 Aug 3;11(8):456. doi: 10.3390/toxins11080456.

Abstract

In the summer of 2018, six dogs exposed to a harmful algal bloom (HAB) of in Martin County Florida (USA) developed clinicopathological signs of microcystin (MC) intoxication (i.e., acute vomiting, diarrhea, severe thrombocytopenia, elevated alanine aminotransferase, hemorrhage). Successful supportive veterinary care was provided and led to survival of all but one patient. Confirmation of MC intoxication was made through interpretation of clinicopathological abnormalities, pathological examination of tissues, microscopy (vomitus), and analytical MC testing of antemortem/postmortem samples (vomitus, blood, urine, bile, liver, kidney, hair). Gross and microscopic examination of the deceased patient confirmed massive hepatic necrosis, mild multifocal renal tubular necrosis, and hemorrhage within multiple organ systems. Microscopy of a vomitus sample confirmed the presence of . Three analytical MC testing approaches were used, including the MMPB (2-methyl-3-methoxy-4-phenylbutyric acid) technique, targeted congener analysis (e.g., liquid chromatography tandem-mass spectrometry of MC-LR), and enzyme-linked immunosorbent assay (ELISA). Total Adda MCs (as MMPB) were confirmed in the liver, bile, kidney, urine, and blood of the deceased dog. Urinalysis (MMPB) of one surviving dog showed a high level of MCs (32,000 ng mL) 1-day post exposure, with MCs detectable >2 months post exposure. Furthermore, hair from a surviving dog was positive for MMPB, illustrating another testable route of MC elimination in canines. The described cases represent the first use of urine as an antemortem, non-invasive specimen to diagnose microcystin toxicosis. Antemortem diagnostic testing to confirm MC intoxication cases, whether acute or chronic, is crucial for providing optimal supportive care and mitigating MC exposure.

摘要

2018 年夏天,佛罗里达州马丁县(美国)的 6 只狗暴露于有害藻类水华(HAB)中,出现微囊藻毒素(MC)中毒的临床病理特征(即急性呕吐、腹泻、严重血小板减少、丙氨酸氨基转移酶升高、出血)。成功提供了支持性兽医护理,除 1 只外所有患者均存活。通过解释临床病理异常、组织病理学检查、显微镜检查(呕吐物)和分析 MC 对生前/死后样本(呕吐物、血液、尿液、胆汁、肝脏、肾脏、毛发)的检测,证实了 MC 中毒。对死亡患者的大体和显微镜检查证实了大量肝坏死、轻度多灶性肾小管坏死以及多个器官系统内出血。对呕吐物样本的显微镜检查证实了 的存在。使用了三种分析 MC 检测方法,包括 MMPB(2-甲基-3-甲氧基-4-苯基丁酸)技术、靶向同系物分析(例如,MC-LR 的液相色谱串联质谱)和酶联免疫吸附测定(ELISA)。在死亡犬的肝脏、胆汁、肾脏、尿液和血液中均证实存在总 Adda MCs(作为 MMPB)。一只幸存犬的尿液分析(MMPB)显示暴露后 1 天即出现高水平的 MCs(32,000ng mL),且在暴露后>2 个月仍可检测到 MCs。此外,一只幸存犬的毛发对 MMPB 呈阳性,这表明 MC 在犬体内的另一种可检测消除途径。这些病例代表了首次将尿液用作诊断微囊藻毒素中毒的生前、非侵入性样本。无论是急性还是慢性,对 MC 中毒病例进行生前诊断检测对于提供最佳支持护理和减轻 MC 暴露至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ae2/6722975/c67fb9905692/toxins-11-00456-g001.jpg

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