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Orthostatic hypotension in ciguatera fish poisoning.
Arch Intern Med. 1992 Oct; 152(10):2131-3.AI

Abstract

PURPOSE

The purpose of this study was to investigate the pathophysiology of persistent orthostatic hypotension in a patient with ciguatera fish poisoning.

METHODS

A patient who became ill and who developed prolonged and symptomatic orthostatic hypotension with ciguatera fish poisoning after eating barracuda is described. Studies of autonomic function included measurements of plasma catecholamine levels in the supine and standing positions, and pressor responses to infusions of norepinephrine, atropine, and propranolol.

RESULTS

Volume depletion was excluded as a cause for hypotension. Our patient showed low plasma catecholamine levels and marked pressor hypersensitivity to norepinephrine infusion. Hypotension and bradycardia were reversed by atropine infusion. The heart rate freed from autonomic influences, ie, after atropine plus propranolol infusion, was normal.

CONCLUSIONS

In ciguatera fish poisoning, orthostatic hypotension appears to be a result of both parasympathetic excess and sympathetic failure.

Authors+Show Affiliations

Northern California Bay Area Poison Control Center, University of California, San Francisco.No affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1417387

Citation

Geller, R J., and N L. Benowitz. "Orthostatic Hypotension in Ciguatera Fish Poisoning." Archives of Internal Medicine, vol. 152, no. 10, 1992, pp. 2131-3.
Geller RJ, Benowitz NL. Orthostatic hypotension in ciguatera fish poisoning. Arch Intern Med. 1992;152(10):2131-3.
Geller, R. J., & Benowitz, N. L. (1992). Orthostatic hypotension in ciguatera fish poisoning. Archives of Internal Medicine, 152(10), 2131-3.
Geller RJ, Benowitz NL. Orthostatic Hypotension in Ciguatera Fish Poisoning. Arch Intern Med. 1992;152(10):2131-3. PubMed PMID: 1417387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orthostatic hypotension in ciguatera fish poisoning. AU - Geller,R J, AU - Benowitz,N L, PY - 1992/10/1/pubmed PY - 1992/10/1/medline PY - 1992/10/1/entrez SP - 2131 EP - 3 JF - Archives of internal medicine JO - Arch Intern Med VL - 152 IS - 10 N2 - PURPOSE: The purpose of this study was to investigate the pathophysiology of persistent orthostatic hypotension in a patient with ciguatera fish poisoning. METHODS: A patient who became ill and who developed prolonged and symptomatic orthostatic hypotension with ciguatera fish poisoning after eating barracuda is described. Studies of autonomic function included measurements of plasma catecholamine levels in the supine and standing positions, and pressor responses to infusions of norepinephrine, atropine, and propranolol. RESULTS: Volume depletion was excluded as a cause for hypotension. Our patient showed low plasma catecholamine levels and marked pressor hypersensitivity to norepinephrine infusion. Hypotension and bradycardia were reversed by atropine infusion. The heart rate freed from autonomic influences, ie, after atropine plus propranolol infusion, was normal. CONCLUSIONS: In ciguatera fish poisoning, orthostatic hypotension appears to be a result of both parasympathetic excess and sympathetic failure. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/1417387/Orthostatic_hypotension_in_ciguatera_fish_poisoning_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/152/pg/2131 DB - PRIME DP - Unbound Medicine ER -