Disease Information for Haff disease/poisoning

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Clinical Manifestations
Signs & Symptoms
Akinetic rigid frozen Posture
Chest Pain
Chest pain, substernal/midline
Non-Pleuritic Chest Pain
Nausea
Postprandial status
Vomiting
Dry mouth/Mucous membranes
Bilateral Calf Pains
Muscle Pain
Muscle stiffness/rigidity
Myalgias
Pain in Extremities/Melalgias
Tender or painful muscles/Myalgias
Numbness/buttocks/thighs
Numbness/distal fingers and toes
Paresthesias
Chest pain exacerbated on deep breathing
Chest tightness/breathing response
Bilateral flank/kidney pain
Coca-Cola dark (coffee colored) urine
Dark urine
URINE Color Red
Others/family same problems/epidemic/exposure
Pain to light touch
Total body pain/truncal/extremities
Clinical Presentation & Variations
Presentation/Fresh water fish Ingestion delay Rhabdomyolysis
Disease Progression
Course/Acute
Course/Acute only
Course/Lethal possible/not usual
Course/Poisoning like onset/Abrupt severe
Course/Prolonged/Protracted convalescence
Course/Self limited usually
Course/Slow curve fast break/over hours
Onset/4-12 hours after exposure
Prognosis/Full recovery usual
Demographics & Risk Factors
Exposure Factors
Exposure/Clusters of cases in a short time
Exposure/Ingestion Buffalo fish/Carp/Fresh water fish
Exposure/Seabirds/Gulls reported deaths/kills
Travel, Geographic & Climate Related Factors
Residence/travel/Baltic/Sweden/Norway
Residence/travel/Europe
Residence/travel/Finland
Residence/travel/Russia/Ukraine
Ethnic or Racial Factors
Ukrainian population
Event, Activity, Behavioral & Seasonal Factors
Event/Community clusters/family members also ill
Event/Seasonal events/exacerbation
Event/Summertime manifestations
Laboratory Tests
Abnormal Lab Findings (Non Measured)
CPK Extreme levels/MB fraction < 5" (Lab)
Transaminase elevation (Lab)
Very High CPK
URINE Color Brown
Abnormal Lab Findings - Increased
ALT (SGPT) (Alanine transferase) (Lab)
Aspartamine aminotransferase (SGOT, AST) (Lab)
AST (SGOT) (aspartamine transferase) (Lab)
CPK/CK/Creatine kinase/Creatine phosphokinase (Lab)
Lactic Dehydrogenase (LDH LH) (Lab)
Myoglobin
URINE Myoglobin
Associated Diseases & Rule outs
Associated Disease & Complications
Acute Renal Failure
Azotemia/Acute
Fish poisoning
Fish poisoning neuropathic syndrome
Food poisoning
Haff disease/poisoning
Myoglobinemia
Myoglobinuria
Rhabdomyolysis
Toxic Nephritis/Nephropathy
Akinetic Rigid Syndrome
Disease Mechanism & Classification
Class
CLASS/Reportable/CDC/National list infection (ex)
CLASS/Muscle involvement/manifestations
Process
PROCESS/Eponymic (category)
PROCESS/INCIDENCE/Acquired disorder
PROCESS/INCIDENCE/Extremely rare disease
PROCESS/INCIDENCE/Regional specific
PROCESS/Poison/specific (category)
Toxin
TOXIN/ Delay/Slow curve fast break/hours
TOXIN/CDC Reportable/Public health issue
TOXIN/Food lethal to chickens/farm animal test
TOXIN/Hexane extractable/heat stable poison/fish
TOXIN/Latency after exposure/ingestion
TOXIN/Poison/Zoologic/stings/bites (category)
TOXIN/Toxin/heat stable (ex)
Synonyms
Synonym
Haff disease poisoning, Synonym/Buffalo fish poisoning, Synonym/Haff disease
Treatment
Drug Therapy - Indication
RX/Fluid/electrolytes intravenous
RX/Hydration/fluids/IV
RX/Mannitol (Osmotrol)
Definition

Fish poisoning from fresh-water fish, burbot, carp-like species (buffalo fish, pike); delayed onset (within 24 hrs) but rhabdomyolysis with myoglobinuria and muscle pain; presents in seasonal community clusters seen in Baltic countries but also mississippi and california; lipid soluble heat stable specific poison (formerly thought to be from arsenic-not proven)

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External Links Related to Haff disease/poisoning
Google
Wikipedia
Merck
Images
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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