Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report

Autores
Vidal, Flavia; Sedan, Daniela Yazmine; D'Agostino, Daniel; Cavalieri, María Lorena; Mullen, Eduardo; Parot Varela, María Macarena; Flores, Cintia; Caixach, Josep; Andrinolo, Dario
Año de publicación
2017
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
In January 2015, a 20-month-old child and her family took part in recreational activities at Carrasco and Malvín beaches (Montevideo, Uruguay). An intense harmful algae bloom (HAB) was developing along the coast at that time. A few hours after the last recreational exposure episode, the family suffered gastrointestinal symptoms which were self-limited except in the child’s case, who was admitted to hospital in Uruguay with diarrhea, vomiting, fatigue, and jaundice. The patient had increased serum levels of liver enzymes and bilirubin and five days later presented acute liver failure. She was referred to the Italian Hospital in Buenos Aires, being admitted with grade II-III encephalopathy and hepatomegaly and requiring mechanical respiratory assistance. Serology tests for hepatitis A, B, and C, Epstein-Barr virus, and cytomegalovirus were negative. Laboratory features showed anemia, coagulopathy, and increased serum levels of ammonium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin. Autoimmune Hepatitis Type-II (AH-II) was the initial diagnosis based on a liver kidney microsomal type 1 antibodies (LKM-1) positive result, and twenty days later a liver transplant was performed. The liver histopathology had indicated hemorrhagic necrosis in zone 3, and cholestasis and nodular regeneration, which were not characteristic of AH-II. LC/ESI-HRMS (liquid chromatography electrospray ionization high-resolution mass spectrometry) analysis of MCs in the explanted liver revealed the presence of Microsytin-LR (MC-LR) (2.4 ng·gr-1 tissue) and [D-Leu1]MC-LR (75.4 ng·gr-1 tissue), which constitute a toxicological nexus and indicate a preponderant role of microcystins in the development of fulminant hepatitis.
Fil: Vidal, Flavia. Hospital Italiano; Argentina
Fil: Sedan, Daniela Yazmine. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: D'Agostino, Daniel. Hospital Italiano; Argentina
Fil: Cavalieri, María Lorena. Hospital Italiano; Argentina
Fil: Mullen, Eduardo. Hospital Italiano; Argentina
Fil: Parot Varela, María Macarena. Hospital Italiano; Argentina
Fil: Flores, Cintia. Instituto de Diagnóstico Ambiental y Estudios del Agua; España
Fil: Caixach, Josep. Instituto de Diagnóstico Ambiental y Estudios del Agua; España
Fil: Andrinolo, Dario. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
CYANOBACTERIA
LIVER FAILURE
MICROCYSTINS
RECREATIONAL EXPOSURE
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/49797
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/49797
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case reportVidal, FlaviaSedan, Daniela YazmineD'Agostino, DanielCavalieri, María LorenaMullen, EduardoParot Varela, María MacarenaFlores, CintiaCaixach, JosepAndrinolo, DarioCYANOBACTERIALIVER FAILUREMICROCYSTINSRECREATIONAL EXPOSUREhttps://purl.org/becyt/ford/1.6https://purl.org/becyt/ford/1In January 2015, a 20-month-old child and her family took part in recreational activities at Carrasco and Malvín beaches (Montevideo, Uruguay). An intense harmful algae bloom (HAB) was developing along the coast at that time. A few hours after the last recreational exposure episode, the family suffered gastrointestinal symptoms which were self-limited except in the child’s case, who was admitted to hospital in Uruguay with diarrhea, vomiting, fatigue, and jaundice. The patient had increased serum levels of liver enzymes and bilirubin and five days later presented acute liver failure. She was referred to the Italian Hospital in Buenos Aires, being admitted with grade II-III encephalopathy and hepatomegaly and requiring mechanical respiratory assistance. Serology tests for hepatitis A, B, and C, Epstein-Barr virus, and cytomegalovirus were negative. Laboratory features showed anemia, coagulopathy, and increased serum levels of ammonium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin. Autoimmune Hepatitis Type-II (AH-II) was the initial diagnosis based on a liver kidney microsomal type 1 antibodies (LKM-1) positive result, and twenty days later a liver transplant was performed. The liver histopathology had indicated hemorrhagic necrosis in zone 3, and cholestasis and nodular regeneration, which were not characteristic of AH-II. LC/ESI-HRMS (liquid chromatography electrospray ionization high-resolution mass spectrometry) analysis of MCs in the explanted liver revealed the presence of Microsytin-LR (MC-LR) (2.4 ng·gr-1 tissue) and [D-Leu1]MC-LR (75.4 ng·gr-1 tissue), which constitute a toxicological nexus and indicate a preponderant role of microcystins in the development of fulminant hepatitis.Fil: Vidal, Flavia. Hospital Italiano; ArgentinaFil: Sedan, Daniela Yazmine. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: D'Agostino, Daniel. Hospital Italiano; ArgentinaFil: Cavalieri, María Lorena. Hospital Italiano; ArgentinaFil: Mullen, Eduardo. Hospital Italiano; ArgentinaFil: Parot Varela, María Macarena. Hospital Italiano; ArgentinaFil: Flores, Cintia. Instituto de Diagnóstico Ambiental y Estudios del Agua; EspañaFil: Caixach, Josep. Instituto de Diagnóstico Ambiental y Estudios del Agua; EspañaFil: Andrinolo, Dario. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaMDPI2017-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/49797Vidal, Flavia; Sedan, Daniela Yazmine; D'Agostino, Daniel; Cavalieri, María Lorena; Mullen, Eduardo; et al.; Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report; MDPI; Toxins; 9; 9; 9-2017; 1-122072-6651CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.3390/toxins9090267info:eu-repo/semantics/altIdentifier/url/http://www.mdpi.com/2072-6651/9/9/267info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:52:34Zoai:ri.conicet.gov.ar:11336/49797instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:52:35.109CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
title Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
spellingShingle Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
Vidal, Flavia
CYANOBACTERIA
LIVER FAILURE
MICROCYSTINS
RECREATIONAL EXPOSURE
title_short Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
title_full Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
title_fullStr Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
title_full_unstemmed Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
title_sort Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report
dc.creator.none.fl_str_mv Vidal, Flavia
Sedan, Daniela Yazmine
D'Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Dario
author Vidal, Flavia
author_facet Vidal, Flavia
Sedan, Daniela Yazmine
D'Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Dario
author_role author
author2 Sedan, Daniela Yazmine
D'Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Dario
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CYANOBACTERIA
LIVER FAILURE
MICROCYSTINS
RECREATIONAL EXPOSURE
topic CYANOBACTERIA
LIVER FAILURE
MICROCYSTINS
RECREATIONAL EXPOSURE
purl_subject.fl_str_mv https://purl.org/becyt/ford/1.6
https://purl.org/becyt/ford/1
dc.description.none.fl_txt_mv In January 2015, a 20-month-old child and her family took part in recreational activities at Carrasco and Malvín beaches (Montevideo, Uruguay). An intense harmful algae bloom (HAB) was developing along the coast at that time. A few hours after the last recreational exposure episode, the family suffered gastrointestinal symptoms which were self-limited except in the child’s case, who was admitted to hospital in Uruguay with diarrhea, vomiting, fatigue, and jaundice. The patient had increased serum levels of liver enzymes and bilirubin and five days later presented acute liver failure. She was referred to the Italian Hospital in Buenos Aires, being admitted with grade II-III encephalopathy and hepatomegaly and requiring mechanical respiratory assistance. Serology tests for hepatitis A, B, and C, Epstein-Barr virus, and cytomegalovirus were negative. Laboratory features showed anemia, coagulopathy, and increased serum levels of ammonium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin. Autoimmune Hepatitis Type-II (AH-II) was the initial diagnosis based on a liver kidney microsomal type 1 antibodies (LKM-1) positive result, and twenty days later a liver transplant was performed. The liver histopathology had indicated hemorrhagic necrosis in zone 3, and cholestasis and nodular regeneration, which were not characteristic of AH-II. LC/ESI-HRMS (liquid chromatography electrospray ionization high-resolution mass spectrometry) analysis of MCs in the explanted liver revealed the presence of Microsytin-LR (MC-LR) (2.4 ng·gr-1 tissue) and [D-Leu1]MC-LR (75.4 ng·gr-1 tissue), which constitute a toxicological nexus and indicate a preponderant role of microcystins in the development of fulminant hepatitis.
Fil: Vidal, Flavia. Hospital Italiano; Argentina
Fil: Sedan, Daniela Yazmine. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: D'Agostino, Daniel. Hospital Italiano; Argentina
Fil: Cavalieri, María Lorena. Hospital Italiano; Argentina
Fil: Mullen, Eduardo. Hospital Italiano; Argentina
Fil: Parot Varela, María Macarena. Hospital Italiano; Argentina
Fil: Flores, Cintia. Instituto de Diagnóstico Ambiental y Estudios del Agua; España
Fil: Caixach, Josep. Instituto de Diagnóstico Ambiental y Estudios del Agua; España
Fil: Andrinolo, Dario. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Centro de Investigaciones del Medio Ambiente; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description In January 2015, a 20-month-old child and her family took part in recreational activities at Carrasco and Malvín beaches (Montevideo, Uruguay). An intense harmful algae bloom (HAB) was developing along the coast at that time. A few hours after the last recreational exposure episode, the family suffered gastrointestinal symptoms which were self-limited except in the child’s case, who was admitted to hospital in Uruguay with diarrhea, vomiting, fatigue, and jaundice. The patient had increased serum levels of liver enzymes and bilirubin and five days later presented acute liver failure. She was referred to the Italian Hospital in Buenos Aires, being admitted with grade II-III encephalopathy and hepatomegaly and requiring mechanical respiratory assistance. Serology tests for hepatitis A, B, and C, Epstein-Barr virus, and cytomegalovirus were negative. Laboratory features showed anemia, coagulopathy, and increased serum levels of ammonium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin. Autoimmune Hepatitis Type-II (AH-II) was the initial diagnosis based on a liver kidney microsomal type 1 antibodies (LKM-1) positive result, and twenty days later a liver transplant was performed. The liver histopathology had indicated hemorrhagic necrosis in zone 3, and cholestasis and nodular regeneration, which were not characteristic of AH-II. LC/ESI-HRMS (liquid chromatography electrospray ionization high-resolution mass spectrometry) analysis of MCs in the explanted liver revealed the presence of Microsytin-LR (MC-LR) (2.4 ng·gr-1 tissue) and [D-Leu1]MC-LR (75.4 ng·gr-1 tissue), which constitute a toxicological nexus and indicate a preponderant role of microcystins in the development of fulminant hepatitis.
publishDate 2017
dc.date.none.fl_str_mv 2017-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/49797
Vidal, Flavia; Sedan, Daniela Yazmine; D'Agostino, Daniel; Cavalieri, María Lorena; Mullen, Eduardo; et al.; Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report; MDPI; Toxins; 9; 9; 9-2017; 1-12
2072-6651
CONICET Digital
CONICET
url http://hdl.handle.net/11336/49797
identifier_str_mv Vidal, Flavia; Sedan, Daniela Yazmine; D'Agostino, Daniel; Cavalieri, María Lorena; Mullen, Eduardo; et al.; Recreational exposure during algal bloom in carrasco beach, uruguay: A liver failure case report; MDPI; Toxins; 9; 9; 9-2017; 1-12
2072-6651
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.3390/toxins9090267
info:eu-repo/semantics/altIdentifier/url/http://www.mdpi.com/2072-6651/9/9/267
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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