Recreational exposure during algal bloom in Carrasco beach,Uruguay: a liver failure case report

Autores
Vidal, Flavia; Sedan, Daniela; D’Agostino, Daniel; Cavalieri, María Lorena; Mullen, Eduardo; Parot Varela, María Macarena; Flores, Cintia; Caixach, Josep; Andrinolo, Darío
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.
Centro de Investigaciones del Medio Ambiente
Materia
Ciencias Exactas
Cyanobacteria
Liver failure
Microcystins
Recreational exposure
Nivel de accesibilidad
acceso abierto
Condiciones de uso
http://creativecommons.org/licenses/by/4.0/
Repositorio
SEDICI (UNLP)
Institución
Universidad Nacional de La Plata
OAI Identificador
oai:sedici.unlp.edu.ar:10915/87459

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spelling Recreational exposure during algal bloom in Carrasco beach,Uruguay: a liver failure case reportVidal, FlaviaSedan, DanielaD’Agostino, DanielCavalieri, María LorenaMullen, EduardoParot Varela, María MacarenaFlores, CintiaCaixach, JosepAndrinolo, DaríoCiencias ExactasCyanobacteriaLiver failureMicrocystinsRecreational exposureIn 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.Centro de Investigaciones del Medio Ambiente2017-08-31info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArticulohttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfhttp://sedici.unlp.edu.ar/handle/10915/87459enginfo:eu-repo/semantics/altIdentifier/issn/2072-6651info:eu-repo/semantics/altIdentifier/doi/10.3390/toxins9090267info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/Creative Commons Attribution 4.0 International (CC BY 4.0)reponame:SEDICI (UNLP)instname:Universidad Nacional de La Platainstacron:UNLP2025-09-29T11:17:13Zoai:sedici.unlp.edu.ar:10915/87459Institucionalhttp://sedici.unlp.edu.ar/Universidad públicaNo correspondehttp://sedici.unlp.edu.ar/oai/snrdalira@sedici.unlp.edu.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:13292025-09-29 11:17:14.154SEDICI (UNLP) - Universidad Nacional de La Platafalse
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
Ciencias Exactas
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
D’Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Darío
author Vidal, Flavia
author_facet Vidal, Flavia
Sedan, Daniela
D’Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Darío
author_role author
author2 Sedan, Daniela
D’Agostino, Daniel
Cavalieri, María Lorena
Mullen, Eduardo
Parot Varela, María Macarena
Flores, Cintia
Caixach, Josep
Andrinolo, Darío
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Ciencias Exactas
Cyanobacteria
Liver failure
Microcystins
Recreational exposure
topic Ciencias Exactas
Cyanobacteria
Liver failure
Microcystins
Recreational exposure
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.
Centro de Investigaciones del Medio Ambiente
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 2017-08-31
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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info:eu-repo/semantics/altIdentifier/doi/10.3390/toxins9090267
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