Abstract
The adverse human health effects associated with the most prolonged and intense exposure known to Pfiesteria piscicida Steidinger & Burkholder cultures and toxin(s) are described. In December 1993, a patient presented with acute illness to the Memory Disorders Clinic of the Bryan Alzheimer's Disease Research Center at Duke University Medical Center with significant cognitive deficits 2 weeks after ceasing occupational laboratory exposure on the recommendation of the evaluating primary care physician. The clinical and exposure histories of this patient are presented. The comprehensive neurological examination findings are reviewed, with attention to the patient's neuropsychological evaluation. Six-week follow-up data illustrate the course of symptom resolution with exposure cessation. This case is presented in an effort to contribute to the gradually accruing evidence of potential central nervous system sequelae of Pfiesteria exposure. The case is discussed in the context of additional cases evaluated at Duke University Medical Center and the complicated scientific framework in which such evaluations proceed while definitive surrogate or biological markers are awaited.
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Selected References
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- Burkholder J. M., Noga E. J., Hobbs C. H., Glasgow H. B., Jr, Smith S. A. New 'phantom' dinoflagellate is the causative agent of major estuarine fish kills. Nature. 1992 Jul 30;358(6385):407–410. doi: 10.1038/358407a0. [DOI] [PubMed] [Google Scholar]
- Glasgow H. B., Jr, Burkholder J. M., Schmechel D. E., Tester P. A., Rublee P. A. Insidious effects of a toxic estuarine dinoflagellate on fish survival and human health. J Toxicol Environ Health. 1995 Dec;46(4):501–522. doi: 10.1080/15287399509532051. [DOI] [PubMed] [Google Scholar]
- Grattan L. M. Current status and future directions for the investigation and management of the human health effects of exposure to Pfiesteria piscicida or Pfiesteria-like dinoflagellates. Md Med J. 1998 May;47(3):148–151. [PubMed] [Google Scholar]
- Grattan L. M., Oldach D., Perl T. M., Lowitt M. H., Matuszak D. L., Dickson C., Parrott C., Shoemaker R. C., Kauffman C. L., Wasserman M. P. Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoflagellates. Lancet. 1998 Aug 15;352(9127):532–539. doi: 10.1016/S0140-6736(98)02132-1. [DOI] [PubMed] [Google Scholar]
- Grattan L. M., Oldach D., Tracy J. K., Greenberg D. R. Neurobehavioral complaints of symptomatic persons exposed to Pfiesteria piscicida or morphologically related organisms. Md Med J. 1998 May;47(3):127–129. [PubMed] [Google Scholar]
- Levin E. D., Schmechel D. E., Burkholder J. B., Deamer-Melia N. J., Moser V. C., Harry G. J. Persisting learning deficits in rats after exposure to Pfiesteria piscicida. Environ Health Perspect. 1997 Dec;105(12):1320–1325. doi: 10.1289/ehp.971051320. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levin E. D., Simon B. B., Schmechel D. E., Glasgow H. B., Jr, Deamer-Melia N. J., Burkholder J. M., Moser V. C., Jensen K., Harry G. J. Pfiesteria toxin and learning performance. Neurotoxicol Teratol. 1999 May-Jun;21(3):215–221. doi: 10.1016/s0892-0362(98)00041-5. [DOI] [PubMed] [Google Scholar]
- McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]