Scombrotoxin poisoning: an important differential diagnosis for anaphylaxis.

We report a case of scombrotoxin poisoning, an acute illness that develops within minutes to hours of eating poorly processed oily fish, such as tuna or mackerel. It presents with symptoms that can mimic an anaphylactic reaction. It is presumed to arise due to ingestion of histamine that is formed by contaminating bacteria that have flourished during periods of suboptimal refrigeration, following capture. Knowledge of this underdiagnosed malady as a potential differential diagnosis for patients presenting with symptoms suggestive of histamine release is important. It is a notifiable condition. The alternative diagnosis of anaphylaxis may have significant lifestyle implications for the patient. This article reports on one such presentation and the way that the diagnosis was explored.

Pathology of Common Diseases of the Thyroid Gland in Port Harcourt

Background: Thyroid diseases are rare in this environment but are more frequent in Western and Northern parts of Nigeria. These diseases present with neck swellings; pains and resulting in high morbidity and mortality rate as well as posing cosmetic problems. Aim: To study the frequency; age distribution and histological types of thyroid diseases. Design/ Setting: A ten-year (1994-2003) retrospective study in Port Harcourt; Nigeria. Methods: Histologic slides were reviewed to ascertain the type of diseases in all cases. The age; sex and clinical presentations were extracted from the histology consultation forms; surgical notes; day books; radiological reports and patient's case file. Results: Thyroid disease accounted for 0.9of biopsies received during the period under review. The lowest frequency occurred in the ages 0 - 10 and 61 -70 years; with one case (1.3) each. The highest occurred in the age group 31-40 years; which recorded 31 cases (38.8). The youngest was a 10 - year old male while the oldest was a 70-year-old female. Eight cases (10.0) occurred in males while 72 (90.0) occurred in females giving a female to male sex ratio of 9:1. Metabolic disease (colloid goitre) was the most common; occurring in 42 (52.0) cases. The least common was inflammatory diseases; 3 (3.8) cases. The most common clinical presentation was neck mass; 64 (80.0) cases. Conclusion: This study confirmed the rarity of thyroid diseases in the Port Harcourt environment and colloid goitre was the most frequent disease. The predominance of females needs an elaborate population based study