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Food poisoning caused by Nassariidaes has occurred frequently in coastal areas of China, especially in summer and autumn. Nassariidaes poisoning can be manifested as lip and tongue paralysis, dizziness, headache, nausea and vomiting, arrhythmia and even respiratory failure. We admitted a case of respiratory failure caused by eating Nassariidaes. After timely respiratory support, hemoperfusion and other active treatment, the patient was recovered and was discharged. This paper summarized clinical characteristics and treatment of Nassariidaes poisoning, in order to provide reference for clinical diagnosis and treatment of similar cases.

Objective: To study the functional changes of liver, kidney, myocardium and gastro-intestine after fish gall bladder poisoning and the pathogenic mechanism of acute renal failure., Methods: The liver and kidney function, myocardial enzyme, urinary N-acetyl-beta-D-glucosaminidase (N-AG), 24 hrs intake and output volume of liquid and kidney B-ultrasonographic examination in 11 patients of severe acute fish gall bladder poisoning were observed. And kidney biopsy was carried out in one patient under B-ultrasonography for understanding the renal pathological changes., Results: All the 11 patients were cured with disappearance of clinical symptoms. After the poisoning the order of the severity of organ damage were kidney, liver, myocardium and gastro-intestine tract. The levels of blood creatinine, blood urea nitrogen, urinary N-AG, glutamic-pyruvic transaminase, total bilirubin were lowered significantly after treatment. Biopsy examination under light microscope showed toxic damage of renal tubules mainly in proximal tubules, and under electron microscope, the pathologic changes were mitochondrial vacuolar degeneration of tubular epithelial cells, swelling of epithelial cells, partial fusion of processes in glomeruli and narrowing of saccular cavity., Conclusion: Fish gall bladder poisoning could cause acute multiple organ dysfunction syndrome (MODS), the affected organs in order of severity of damage were kidney, liver, myocardium and gastro-intestine tract. In kidney the damage was mainly at the proximal tubules. Urinary NAG is a sensitive criterion for determining the diagnosis and prognosis of renal tubular dysfunction.

During the past three years on investigating and studying the poisoning of eating Horseshoe crab, it has been discovered that the major cause of the poisoning on eating Horseshoe crab in south region along the seacoast of China was taking tetrodotoxin from Carcinoscorpius rotundicauda by mistake; the symptoms of some others from eating Horseshoe crab were the result of allergic reactions from eating Tachypleus tridentatuscause, similar to the reactions from eating shrimp or crab, and which could be cured with chlorpheniramine. The effective prevention measures are not eating Horseshoe crab, especially the young ones. The size of young Carcinoscorpius rotundicauda is similar to the size of the nonpoisonous Tachypleus tridentatuscause. It is very easy to be confused and easy to eat by mistake. The treatment of the poisoning from eating Horseshoe crab is similar to the treatment of tetrodotoxin by removing the toxins from body.