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Transient Diabetes Insipidus Associated with Tetrodotoxin Intoxication: A Case Report
Journal of the Korean Society of Emergency Medicine ; : 230-235, 2013.
Article in Korean | WPRIM | ID: wpr-37228
ABSTRACT
Ingestion of puffer fish can result in severe and potentially lethal intoxication, referred to as tetrodotoxin intoxication. Tetrodotoxin is a potent neurotoxin well known for its ability to ability neuromuscular function. Tetrodotoxin is a specific and potent blocker of axonal sodium channel; it may block sodium channels in the axon of the neurons of the neurohypophysis, thereby inhibiting the release of vasopressin and causing diabetes insipidus neurotoxin. To our knowledge, previous report on diabetes insipidus causing tetrodotoxin is the only one case in Singapore. A married couple (69-year-old man and 57-year-old woman) ingested two green rough-backed puffer fish (Lagocephalus lunaris). They complained of paresthesia on perioral area and extremity and developed not only grade IV intoxication but also an increased urine output (4455 ml/day and 5035 ml/day), elevated serum sodium (157.4 mEq/L and 166.7 mEq/L) and elevated serum osmolality (324 mosmol/kg and 339 mosmol/kg), which suggested the development of diabetes insipidus. The administration of desmopressin nasal spray was successful in normalizing urine volume. Both were discharged on 20th and 18th hospital day, respectively, without any complications.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Osmolar Concentration / Paresthesia / Pituitary Gland, Posterior / Sodium / Axons / Tetrodotoxin / Vasopressins / Sodium Channels / Tetraodontiformes / Deamino Arginine Vasopressin Language: Korean Journal: Journal of the Korean Society of Emergency Medicine Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Osmolar Concentration / Paresthesia / Pituitary Gland, Posterior / Sodium / Axons / Tetrodotoxin / Vasopressins / Sodium Channels / Tetraodontiformes / Deamino Arginine Vasopressin Language: Korean Journal: Journal of the Korean Society of Emergency Medicine Year: 2013 Type: Article