Haff's disease is a rare disease that appears suddenly and causes intense pain in the muscles due to the destruction of muscle tissue, in addition to black urine 24 hours after the consumption of contaminated freshwater fish. It is believed that the fish must be contaminated with some biological toxin but since the appearance of this disease in the 1920s, until today, this toxin has not yet been identified.
Most of the time the disease is not so severe that it can lead to death, and most affected patients get better with quick recovery, but sometimes, when treatment is not carried out, the disease can get worse and lead to more serious conditions., such as multiple organ failure.
What symptoms
The symptoms of Haff's disease appear between 2 to 24 hours after consuming well-cooked but contaminated fish or crustaceans and can be:
- Pain and stiffness in the muscles, which is very strong and suddenly appears; Urine very dark, brown or black, similar to the color of tea or coca-cola; Numbness and loss of strength that affects the whole body.
What is the diagnosis
To arrive at the diagnosis of the disease, the doctor can order urine, blood tests and a CT scan. The blood test can show an increase in CK, which can be 5 times above the expected value, and which indicates muscle necrosis and other important substances to reach the conclusion that it is Haff's disease.
As this is a rare disease, it is common for the doctor to have other suspicions before determining the diagnosis, being able to assess freshwater fish that have been ingested in the last 24 hours.
In addition, it is also important to rule out other situations in which rhabdomyolysis also occurs, such as arsenic, mercury or organophosphate pesticides.
Possible causes
The causes of Haff's disease are not fully known, however, it is known that what is common in all patients diagnosed with donça, is the ingestion of fish or crustaceans like crayfish, on the same day or the day before the appearance of symptoms.
The most accepted theory by researchers is that the food should be contaminated with some toxin that is causing muscle pain, affecting the kidneys, blood clotting, the liver and the digestive system. The toxin does not change the flavor of the food, nor does it change its color, nor is it destroyed by the normal cooking process, so any fish or crustacean can be contaminated and the person ingest, without knowing it.
Some seafood that has been eaten by patients diagnosed with Haff's disease includes Tambaqui, Pacu-Manteiga, Pirapitinga and Lagostim and most of the cases have occurred in times of epidemic of this disease.
Initially, it was suspected that this disease was caused by arsenic or mercury poisoning, but it has not been proven.
How the treatment is done
To control the symptoms it is common for the doctor to indicate painkillers to be able to control the pain and try to calm the patient, but sometimes only opioids are effective to relieve the discomfort that the disease causes.
Usually the person needs to be admitted to the hospital to receive the appropriate treatment, which can be done with serum in the vein, to prevent dehydration or kidney failure, caused by excess muscle waste in the blood. It is also recommended to drink a lot of water, so that the recovery is faster, being able to be administered serum in the vein, of about 10 liters per day.
In addition, diuretic remedies can also be used to produce more urine and cleanse the body faster, and it may sometimes be necessary to use sodium bicarbonate to normalize kidney function.
The person is discharged when the tests are normal and there is no risk of serious kidney damage, such as kidney failure.
