Clinical features of Haff disease and myositis after the consumption of boiled brackish water crayfish: a retrospective study of 96 cases at a single centre

Intern Emerg Med. 2018 Dec;13(8):1265-1271. doi: 10.1007/s11739-018-1870-6. Epub 2018 May 8.

Abstract

The present study describes the difference in clinical features between the patients with Haff disease and crayfish-related myositis (CRM) after crayfish consumption. This was a single-centre, retrospective analysis at the Emergency Department of the Drum Tower Hospital of Nanjing University School of Medicine from July to August of 2016. The baseline information came from the Electronic Medical Record System at the institution. Totally 96 patients were included, of whom 52 patients were confirmed to have Haff disease and 44 patients were CRM. The illness predominately occurs in summer and most of them (55/96) are female. The primary clinical features are myalgia, muscle allodynia and back and body pain. Statistical differences in the baseline CK, CK-MB, myoglobin, and the WBC count exist between the Haff disease and CRM groups (P < 0.05). The serum levels of CK and CK-MB increase in the second (a median time 29.2 ± 7.4 h) or third day (a median time 54.8 ± 9.3 h) of disease course, and then rapidly decreased to normal levels, while the levels of myoglobin peak at the admission (a median time 7.7 ± 6.4 h) and became normal after admission. There were no fatalities or complications during this study. All 96 patients recovered in a week. Of them, 75 were followed-up within 1 month and none had recurrence. The Haff disease and CRM after boiled crayfish consumption reflect a different severity of muscle injury, and reveal similar clinical characteristics and most of the laboratory values. The overall prognosis of both is good.

Keywords: Crayfish; Haff disease; Myositis; Rhabdomyolysis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Astacoidea / pathogenicity*
  • Chi-Square Distribution
  • Creatine Kinase / analysis
  • Creatine Kinase / blood
  • Feeding Behavior / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myalgia / etiology
  • Myalgia / physiopathology
  • Myositis / blood
  • Myositis / etiology*
  • Myositis / physiopathology
  • Pain / etiology
  • Pain / physiopathology
  • Retrospective Studies
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / etiology*
  • Rhabdomyolysis / physiopathology
  • Saline Waters
  • Statistics, Nonparametric

Substances

  • Creatine Kinase