Featured Research

from universities, journals, and other organizations

Highly Concentrated Botulinum Preparation For Cosmetic Injections Can Result In Severe Illness

Date:
November 26, 2006
Source:
JAMA and Archives Journals
Summary:
An examination of four cases of botulism following cosmetic injections to the face indicates that the adults received a highly concentrated, unlicensed preparation that resulted in toxin levels up to 40 times the estimated human lethal dose, according to a report in the Nov. 22/29 issue of JAMA.

An examination of 4 cases of botulism following cosmetic injections to the face indicates that the adults received a highly concentrated, unlicensed preparation that resulted in toxin levels up to 40 times the estimated human lethal dose, according to a report in the November 22/29 issue of JAMA.

Botulism is a rare paralytic illness caused by the toxins of the spore-forming bacterium Clostridium botulinum and toxin-producing strains of Clostridium baratii and Clostridium butyricum. Botulism, left untreated, may result in respiratory failure and death, according to background information in the article. Two botulinum toxin preparations are licensed in the United States by the U.S. Food and Drug Administration for clinical use, BOTOX (crystalline toxin type A); and Myobloc/Neurobloc (toxin type B). Although botulinum toxin A is available by prescription for cosmetic and therapeutic use, no cases of botulism with detectable serum toxin have previously been attributed to cosmetic or therapeutic botulinum toxin injections. On November 27, 2004, four suspected botulism case-patients with a link to cosmetic botulinum toxin injections were reported to the Centers for Disease Control and Prevention.

Daniel S. Chertow, M.D., M.P.H., of the CDC, Atlanta, and colleagues investigated various aspects of the four suspected cases of botulism. They found that clinical characteristics of the four case-patients were consistent with those of naturally occurring botulism. All case-patients had been injected with a highly concentrated, unlicensed preparation of botulinum toxin A, intended for laboratory research, labeled accordingly, and not licensed or intended for human use.

Clinic staff had diluted a 100-g vial of pure neurotoxin with diluent and drew up the resulting solution into syringes for clinical use. The physician working at the clinic administered 4 case-patients (including himself) 4 to 6 injections of this toxin solution in the facial area. All the patients eventually reported symptoms of progressive weakness and cranial neuropathies (abnormality of the nerves that control a number of functions, including movement of the facial muscles and swallowing), with two patients experiencing shortness of breath.

The researchers report the patients may have received doses 2,857 times the estimated human lethal dose by injection. Pretreatment serum toxin levels in 3 of the 4 case-patients were equivalent to 21 to 43 times the estimated human lethal dose; pretreatment serum from the fourth epidemiologically linked case-patient was not available. A 100-g vial of toxin taken from the same manufacturer's lot as toxin administered to the case-patients contained a toxin amount sufficient to kill approximately 14,286 adults by injection if disseminated evenly.

"Botulism is a potentially fatal disease, which invariably presents with acute bilateral cranial neuropathies, regardless of exposure mechanism. Early recognition of botulism, treatment in an intensive care setting, provision of mechanical ventilation when indicated, and rapid administration of antitoxin (optimally within 12 hours of presentation) have been associated with improved clinical outcome. Suspected cases of botulism should be reported immediately to local health authorities to facilitate rapid epidemiological investigation, provision of antitoxin when indicated, and prevention of further cases," the researchers write.

"Physicians and patients must be aware of the hazards associated with illegitimate use of unlicensed botulinum toxin products. Only licensed products should be used clinically. Entities inappropriately marketing, selling, or using unlicensed botulinum toxin products should be sought and subjected to full criminal and civil penalties. The Code of Federal Regulations should be modified to reduce the weight threshold of individual shipments subject to regulation and should require researchers to provide legal documentation of credentials and adequate laboratory facilities prior to shipment of toxin," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "Highly Concentrated Botulinum Preparation For Cosmetic Injections Can Result In Severe Illness." ScienceDaily. ScienceDaily, 26 November 2006. <www.sciencedaily.com/releases/2006/11/061126121136.htm>.
JAMA and Archives Journals. (2006, November 26). Highly Concentrated Botulinum Preparation For Cosmetic Injections Can Result In Severe Illness. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2006/11/061126121136.htm
JAMA and Archives Journals. "Highly Concentrated Botulinum Preparation For Cosmetic Injections Can Result In Severe Illness." ScienceDaily. www.sciencedaily.com/releases/2006/11/061126121136.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

House Republicans Vote to Sue Obama Over Healthcare Law

House Republicans Vote to Sue Obama Over Healthcare Law

Reuters - US Online Video (July 31, 2014) The Republican-led House of Representatives votes to sue President Obama, accusing him of overstepping his executive authority in making changes to the Affordable Care Act. Mana Rabiee reports. Video provided by Reuters
Powered by NewsLook.com
Despite Health Questions, E-Cigs Are Beneficial: Study

Despite Health Questions, E-Cigs Are Beneficial: Study

Newsy (July 31, 2014) Citing 81 previous studies, new research out of London suggests the benefits of smoking e-cigarettes instead of regular ones outweighs the risks. Video provided by Newsy
Powered by NewsLook.com
Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins