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Star fruit intoxication in uraemic patients: case series and review of the literature.
Intern Med J. 2003 Jul; 33(7):314-6.IM

Abstract

Star fruit, belonging to the Oxalidaceae family, species Averrhoa carambola, is a popular fruit among Orientals. There have been reports of hiccup, confusion, and occasional fatal outcomes in uraemic patients after ingestion of star fruit. An excitatory neurotoxin from star fruit has been implicated although the exact nature of this toxic substance has not been identified. A group of seven patients is described from the dialysis centres at Queen Mary and Tung Wah Hospitals who developed symptoms including hiccup, confusion, vomiting, impaired consciousness, muscle twitching and hyperkalaemia shortly after ingestion of star fruit. Symptoms of most patients resolved after intensified dialysis or spontaneously, and no mortality was observed. The close temporal relationship of ingestion of star fruit and onset of symptoms strongly suggests the existence of a causal relationship between the two. It is recommended that uraemic patients should totally abstain from star fruit due to these rare but potentially fatal complications. The clinical manifestations of other reported series and current evidence for the possible candidate(s) of the neurotoxin are discussed.

Authors+Show Affiliations

Tse KC
Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Yip PS
No affiliation info available
Lam MF
No affiliation info available
Choy BY
No affiliation info available
Li FK
No affiliation info available
Lui SL
No affiliation info available
Lo WK
No affiliation info available
Chan TM
No affiliation info available
Lai KN
No affiliation info available

MeSH

Acute Kidney InjuryAdultAgedFemaleFollow-Up StudiesFruitHong KongHumansKidney Function TestsMaleMiddle AgedNeurotoxicity SyndromesNeurotoxinsPlant PoisoningRenal DialysisRisk AssessmentSampling StudiesSeverity of Illness IndexSurvival AnalysisTreatment OutcomeUremia

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

12823678

Citation

Tse, K-C, et al. "Star Fruit Intoxication in Uraemic Patients: Case Series and Review of the Literature." Internal Medicine Journal, vol. 33, no. 7, 2003, pp. 314-6.
Tse KC, Yip PS, Lam MF, et al. Star fruit intoxication in uraemic patients: case series and review of the literature. Intern Med J. 2003;33(7):314-6.
Tse, K. C., Yip, P. S., Lam, M. F., Choy, B. Y., Li, F. K., Lui, S. L., Lo, W. K., Chan, T. M., & Lai, K. N. (2003). Star fruit intoxication in uraemic patients: case series and review of the literature. Internal Medicine Journal, 33(7), 314-6.
Tse KC, et al. Star Fruit Intoxication in Uraemic Patients: Case Series and Review of the Literature. Intern Med J. 2003;33(7):314-6. PubMed PMID: 12823678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Star fruit intoxication in uraemic patients: case series and review of the literature. AU - Tse,K-C, AU - Yip,P-S, AU - Lam,M-F, AU - Choy,B-Y, AU - Li,F-K, AU - Lui,S-L, AU - Lo,W-K, AU - Chan,T-M, AU - Lai,K-N, PY - 2003/6/26/pubmed PY - 2003/12/11/medline PY - 2003/6/26/entrez SP - 314 EP - 6 JF - Internal medicine journal JO - Intern Med J VL - 33 IS - 7 N2 - Star fruit, belonging to the Oxalidaceae family, species Averrhoa carambola, is a popular fruit among Orientals. There have been reports of hiccup, confusion, and occasional fatal outcomes in uraemic patients after ingestion of star fruit. An excitatory neurotoxin from star fruit has been implicated although the exact nature of this toxic substance has not been identified. A group of seven patients is described from the dialysis centres at Queen Mary and Tung Wah Hospitals who developed symptoms including hiccup, confusion, vomiting, impaired consciousness, muscle twitching and hyperkalaemia shortly after ingestion of star fruit. Symptoms of most patients resolved after intensified dialysis or spontaneously, and no mortality was observed. The close temporal relationship of ingestion of star fruit and onset of symptoms strongly suggests the existence of a causal relationship between the two. It is recommended that uraemic patients should totally abstain from star fruit due to these rare but potentially fatal complications. The clinical manifestations of other reported series and current evidence for the possible candidate(s) of the neurotoxin are discussed. SN - 1444-0903 UR - https://www.unboundmedicine.com/medline/citation/12823678/Star_fruit_intoxication_in_uraemic_patients:_case_series_and_review_of_the_literature_ DB - PRIME DP - Unbound Medicine ER -