Naslov
Neurotoxin-induced fibromyalgia or fibromyalgia after ciguatera (tilapia fish) poisoning?

Autori
Bilić. Ervina ; Hajnšek, Sanja ; Kello, Nina ; Zemba Čilić, Andrea ; Čerimagić, Denis ; Bilić, Ernest ; Žagar, Marija ; Ninčević Gladan, Živana

Kolaboracija
Icahn School of Medicine, Queens Hospital Center, New York, NY, USA

Izvornik
Neurologia Croatica (0353-8842) 63 (2014), 1-2; 55-59

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Fibromyalgia ; Ciguatera poisoning ; Global warming ; Antidepressants

Sažetak
Background: Global climate change and the consequent increase in seawater temperatures have not spared the Adriatic Sea, leaving trace on its flora and fauna. Due to rises in seawater temperatures over the last few years, the dinoflagellatae algae that contain a potent neurotoxin, ciguatera, can now be found in the Adriatic Sea. The chronic form of ciguatera poisoning is characterized by chronic fatigue, chronic pain and diffuse sensory disturbances. Diagnosis of fibromyalgia is based on clinical signs and diagnostic criteria, with pain in the characteristic trigger points being the leading symptom. The clinical presentations of fibromyalgia and the chronic form of ciguatera poisoning largely overlap, and it is known that fibromyalgia may develop after infections with neurotrophic viruses or bacteria, as well as after certain poisonings. Case reports: This paper presents two patients with ciguatera poisoning that developed the chronic pain syndrome, the characteristics of which meet the criteria for the diagnosis of fibromyalgia. In both patients, excellent results were achieved using antidepressants in the treatment of their pain. Conclusions: Clinical studies are needed to assess the efficacy of antidepressants in pain treatment in the chronic form of ciguatera poisoning. Since ciguatera neurotoxin is currently present in plants found in the Adriatic Sea, we believe that this paper may help in the understanding and differential diagnosis of acute and chronic neurological syndromes that develop after the ingestion of fish from the Adriatic Sea.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA