Ciguatera oder wieso bei der Kälteallodynie nach dem Fischverzehr gefragt werden sollte

Zusammenfassung

Ciguatoxine sind potente, von Mikroalgen produzierte, marine Biotoxine, die sich in tropischen Raubfischen, lokal und saisonal unterschiedlich stark, anreichern können. Kurze Zeit nach dem Fischverzehr treten gastrointestinale, neurologische und/oder kardiovaskuläre Vergiftungssymptome auf. Durch die hohe Affinität der Toxine zu neuronalen Natriumkanälen sind neurologische Symptome für Ciguatera-Vergiftungen charakteristisch. Nahezu pathognomonisch ist dabei die Kälteallodynie, bei der kalte Oberflächen als heiß, schmerzhaft oder extrem unangenehm empfunden werden. Durch Importe von Tropenfisch tritt Ciguatera zunehmend auch in gemäßigten Klimazonen auf. Wir erläutern anhand zweier Fälle die Besonderheiten dieser Fischvergiftung.

Abstract

Ciguatoxins (CTX) are potent marine biotoxins produced by microalgae, which may accumulate seasonally, and which are locally variable in tropical predatory fish. Gastrointestinal, neurologic and/or cardiovascular symptoms occur shortly after the consumption of fish. Due to the high affinity of CTX to neuronal sodium channels, neurologic symptoms constitute a hallmark of ciguatera fish poisoning (CFP). Almost pathognomonic for CFP is an alteration of temperature perception (cold allodynia), in which cold surfaces are perceived as hot, painful, or produce dysesthesia (unpleasant, abnormal sensation). Increasing imports of tropical fish have led to more frequent reports of ciguatera in temperate climatic zones. We illustrate the specific features of CFP by reporting two cases due to imported tropical fish.

Schlüsselwörter

Ciguatera - Ciguatoxin - Fischvergiftung - Neurotoxin - Kälteallodynie

Key words

ciguatera - ciguatoxin - fish poisoning - neurotoxin - cold allodynia

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