Tsepo Goerttler, Martin B Dorner, Christina van der Linden, Ricardo Kienitz, Stephan Petrik, Stephan Blechinger, Jonah Spickschen, Iris R Betz, Carl Hinrichs, David Steindl, Frederike Weber, Thomas Musacchio, Gilbert Wunderlich, Maria Adele Rueger, Michael T Barbe, Haidar Dafsari, Seda Demir, Sriramya Lapa, Pia S Zeiner, Adam Strzelczyk, Peter Tinnemann, Christian Kleine, Andreas Totzeck, Stephan Klebe, Agata Mikolajewska, Brigitte G Dorner, Elisabeth Fertl, Christian Grefkes-Hermann, Gereon Fink, Christoph Kleinschnitz, Tim Hagenacker
{"title":"胃内注射肉毒杆菌神经毒素后的先天性肉毒中毒--一次大爆发。","authors":"Tsepo Goerttler, Martin B Dorner, Christina van der Linden, Ricardo Kienitz, Stephan Petrik, Stephan Blechinger, Jonah Spickschen, Iris R Betz, Carl Hinrichs, David Steindl, Frederike Weber, Thomas Musacchio, Gilbert Wunderlich, Maria Adele Rueger, Michael T Barbe, Haidar Dafsari, Seda Demir, Sriramya Lapa, Pia S Zeiner, Adam Strzelczyk, Peter Tinnemann, Christian Kleine, Andreas Totzeck, Stephan Klebe, Agata Mikolajewska, Brigitte G Dorner, Elisabeth Fertl, Christian Grefkes-Hermann, Gereon Fink, Christoph Kleinschnitz, Tim Hagenacker","doi":"10.1186/s42466-024-00350-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI.</p><p><strong>Methods: </strong>We retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany.</p><p><strong>Results: </strong>Seven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits.</p><p><strong>Conclusion: </strong>Our study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"52"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520667/pdf/","citationCount":"0","resultStr":"{\"title\":\"Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak.\",\"authors\":\"Tsepo Goerttler, Martin B Dorner, Christina van der Linden, Ricardo Kienitz, Stephan Petrik, Stephan Blechinger, Jonah Spickschen, Iris R Betz, Carl Hinrichs, David Steindl, Frederike Weber, Thomas Musacchio, Gilbert Wunderlich, Maria Adele Rueger, Michael T Barbe, Haidar Dafsari, Seda Demir, Sriramya Lapa, Pia S Zeiner, Adam Strzelczyk, Peter Tinnemann, Christian Kleine, Andreas Totzeck, Stephan Klebe, Agata Mikolajewska, Brigitte G Dorner, Elisabeth Fertl, Christian Grefkes-Hermann, Gereon Fink, Christoph Kleinschnitz, Tim Hagenacker\",\"doi\":\"10.1186/s42466-024-00350-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Intragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI.</p><p><strong>Methods: </strong>We retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany.</p><p><strong>Results: </strong>Seven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits.</p><p><strong>Conclusion: </strong>Our study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.</p>\",\"PeriodicalId\":94156,\"journal\":{\"name\":\"Neurological research and practice\",\"volume\":\"6 1\",\"pages\":\"52\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520667/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurological research and practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s42466-024-00350-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurological research and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s42466-024-00350-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:在一些欧洲国家,胃内肉毒杆菌神经毒素注射(IBNI)作为一种安全有效的减肥措施,在私人医疗部门被标示外提供。2023 年 2 月和 3 月,在土耳其接受 IBNI 治疗后,欧洲多个国家爆发了先天性肉毒中毒事件。本系列病例描述了 IBNI 治疗后严重先天性肉毒中毒的临床特征:我们回顾性总结了在奥地利和德国突然爆发的肉毒中毒事件中,接受 IBNI 治疗后发生的 10 例重症先天性肉毒中毒病例的临床过程以及急诊科和重症监护室的干预措施:结果:10例患者中有7例最初表现出肉毒中毒的特征性症状,包括复视、吞咽困难、构音障碍、发音障碍和下肢瘫痪。所有患者均住院治疗,其中六人住在重症监护室,部分患者需要机械通气。所有患者均已康复出院,没有出现相关的永久性缺陷:我们的研究突出显示了这起先天性肉毒中毒疫情中的十个临床病例,这是全球报告的最大一起疫情。临床医生应了解涉及肉毒杆菌神经毒素的医疗程序的相关风险,并确保采取措施将先天性肉毒中毒的风险降至最低。
Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak.
Background: Intragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI.
Methods: We retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany.
Results: Seven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits.
Conclusion: Our study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.