Respiratory paralysis in a patient with myasthenia gravis after ingestion of marine carnivorous gastropods: A case report

Intern Med. 2024 Apr 9. doi: 10.2169/internalmedicine.2828-23. Online ahead of print.

Abstract

The salivary glands of marine carnivorous gastropods contain tetramines, which usually cause mild symptoms of poisoning. However, these symptoms may be fatal in rare cases. A 58-year-old woman with a history of myasthenia gravis complained of dyspnea after consuming marine carnivorous gastropods with intact salivary glands. Upon arrival at the hospital, her blood gas analysis revealed type II respiratory failure with a pCO2 of 154 mmHg. Tracheal intubation was immediately performed. Her respiratory condition improved the following day, and she therefore could be weaned off the ventilator. Tetramine poisoning can be fatal for patients with certain underlying medical conditions.

Keywords: Poisoning; Respiratory failure; Tetramine; marine carnivorous gastropod; myasthenia gravis.