Two Case of Botulism Developed after Endoscopic Clostridium Botulinum Toxin Administration to the Stomach Wall

Year 2024, Volume: 6 Issue: 2, 35 - 37, 31.08.2024

Fatih Cemal Tekin , Belgin Akıllı , Melahat Şimşek , Fatma Selcen Öcal , Emin Fatih Vişneci , Aysegul Demir

https://doi.org/10.51262/ejtox.1527708

Abstract

Every year, the United States records about 200 cases of botulism. Those who inject substances such as heroin, use homemade alcohol, and eat improperly prepared canned food are at risk of contracting this extremely rare disease. As seen in this case, those treated with Clostridium Botulinum Toxin are also considered to be in the risk group. However, iatrogenic botulism cases are much rare; and in the literature, case reports of botulism after intragastric Clostridium Botulinum Toxin administration are rare. We aimed to present these cases to draw attention to this rare condition in patients who presented to the emergency department with complaints such as weakness, dyspnea, and diarrhea.

Keywords

Stomach, Botox, Adverse effects, Iatrogenic disease

MİDE DUVARINA ENDOSKOPİK KLOSTRIDYUM BOTULINUM TOKSİNİ UYGULAMASI SONRASI GELİŞEN İKİ BOTULİZM OLGUSU

Abstract

Amerika Birleşik Devletleri'nde yılda yaklaşık 200 botulizm vakası kaydedilmektedir. Son derece nadir görülen bu hastalığa yakalanma açısından; eroin gibi maddeleri vücuduna enjekte edenler, ev yapımı alkol kullananlar ve yanlış hazırlanmış konserve yiyecekleri yiyenler risk altındadır. Bu vakada da görüldüğü gibi Clostridium Botulinum Toksini ile tedavi edilenlerin de riskli grupta olduğu düşünülmektedir. Ancak iyatrojenik botulizm vakaları çok daha nadirdir ve literatürde intragastrik Clostridium Botulinum Toksin uygulaması sonrası gelişen botulizm vaka sunumu nadirdir. Acil servise halsizlik, nefes darlığı, ishal gibi şikayetler ile başvuran hastalarda bu nadir duruma dikkat çekmek amacıyla bu olguları sunmayı amaçladık.

Keywords

Mide, Botoks, İstenmeyen etkiler, İyatrojenik hastalık

References

• Botulism: Centers for Disease Control and Prevention; [16.03.2023]. Available from: https://www.cdc.gov/botulism/ index.html.
• Tiwari A, Nagalli S. Clostridium Botulinum. StatPearls; [16.03.2023]. Treasure Island (FL): StatPearls Publishing; 2022.
• Pegram PS, Stone SM. Botulism: Uptodate [16.03.2023]; [Available from: https://www.uptodate.com/ contents/botulism?search=botilizm&source=search_ result&selectedTitle=1~87&usage_type=default&display_ rank=1.
• Jeffery IA, Karim S. Botulism. StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
• Botulism: World Health Organization; [16.03.2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/ botulism.
• Dorner MB, Wilking H, Skiba M, Wilk L, Steinberg M, Worbs S, et al. A large travel associated outbreak of iatrogenic in four European countries following intragastric botulinum neurotoxin injections for weight reduction, Türkiye, February to March 2023. Euro Surveill. 2023 Jun;28(23):2300203. doi: 10.2807/1560-7917.ES.2023.28.23.2300203.
• Gök MA, Demir M, Yeğen F, Kafadar MT, Şenol M, Kocaoğlu AE, et al. Obezite Tedavisinde Endoskopik Mide Içi Botulinum Toksin-A Etkili mi? Kocaeli Tıp Dergisi Kocaeli Tıp Dergisi 2022;11(2):149-52.
• Çolak, B., Yormaz, S., Ece, İ., Acar, F., Yılmaz, H., Alptekin, H. Morbid Obezite Cerrahisi ve Komplikasyonları. Selçuk Tıp Derg, 32(1), 19-22.
• People at Risk: Centers for Disease Control and Prevention; [Available from: https://www.cdc.gov/botulism/people-at-risk. html.
• Dhaked RK, Singh MK, Singh P, Gupta P. Botulinum toxin: bioweapon & magic drug. IJMR 2010;132(5):489-03.
• Nikiforov, V. V. Botulinum neurotoxin is both poison and medicine: botulinum therapy and iatrogenic botulism. Epidemiology & Infection 2022; 27(6): 341-59.
• Eser F, Hasanoğlu İ, Kayaaslan B, Kaya Kalem A, Bilen Ş, Orhan G, Güner R. Iatrogenic botulism cases after gastric and axillary application of botulinum toxin and review of literature. J Infect Dev Ctries. 2024 Mar 31;18(3):480-487. doi: 10.3855/ jidc.18868.
• Topazian M, Camilleri M, De La Mora-Levy J, Enders FB, Foxx-Orenstein AE, Levy MJ, et al. Endoscopic ultrasoundguided gastric botulinum toxin injections in obese subjects: a pilot study. Obes Surg 2008;18:401-7.
• Drug Monograph Abobotulinum toxin A: Clinicalkey; [17.03.2023]. Available from: https://www.clinicalkey.com/#!/ content/drug_monograph/6-s2.0-3663.
• Rao AK, Lin NH, Griese SE, Chatham-Stephens K, Badell ML, Sobel J. Clinical Criteria to Trigger Suspicion for Botulism: An Evidence-Based Tool to Facilitate Timely Recognition of Suspected Cases During Sporadic Events and Outbreaks. CID 2017;66(suppl_1):38-42.
• Tekçe HD, Deymeer F, Serdaroğlu PO, Parman YJTJN. Botulinum Toksin Tip A Enjeksiyonu Sonrası Açığa Çıkan Myasthenia Gravis Olgusu. Turk J Neurol 2016;22:143-4.
• Fung HT, Chan KM, Lam SKT. A review on iatrogenic botulism. HKJ 2020;27(6):356-67.