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Sustained low-efficiency daily diafiltration with hemoperfusion as a therapy for severe star fruit intoxication: a report of two cases.
Ren Fail. 2011; 33(8):837-41.RF

Abstract

Over the past decade, star fruit (Averrhoa carambola) intoxication decreased in the Taiwanese society due to improved public education on chronic kidney disease (CKD). Various complications including hiccups, altered levels of consciousness, coma, and seizures have been reported in individuals with renal failure who ingested fresh star fruit or star fruit juice. A high mortality rate (from 33 to 80%) was observed in patients with altered levels of consciousness, despite prompt dialysis and supportive care. According to previous case reports, the proposed treatment of choice for severe star fruit intoxication may be continuous renal replacement therapy with or without hemoperfusion. We report two cases of star fruit intoxication with stage V CKD (one case is predialysis) presenting with coma and generalized tonic-clonic seizures. The two patients were treated with sustained low-efficiency daily diafiltration (SLEDD-f) and charcoal hemoperfusion. Status epilepticus was controlled fairly quickly after treatment with SLEDD-f and hemoperfusion. However, the outcomes in this report are still poor (both remained comatose; one of two patients died). Currently, there are no data for the use of SLEDD-f with hemoperfusion for severe star fruit intoxication. SLEDD-f with charcoal hemoperfusion may play a role in managing refractory status epilepticus in patients with severe star fruit poisoning.

Authors+Show Affiliations

Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21770853

Citation

Wu, Chia-Lin, et al. "Sustained Low-efficiency Daily Diafiltration With Hemoperfusion as a Therapy for Severe Star Fruit Intoxication: a Report of Two Cases." Renal Failure, vol. 33, no. 8, 2011, pp. 837-41.
Wu CL, Chiu PF, Yang Y, et al. Sustained low-efficiency daily diafiltration with hemoperfusion as a therapy for severe star fruit intoxication: a report of two cases. Ren Fail. 2011;33(8):837-41.
Wu, C. L., Chiu, P. F., Yang, Y., Wen, Y. K., Chiu, C. C., & Chang, C. C. (2011). Sustained low-efficiency daily diafiltration with hemoperfusion as a therapy for severe star fruit intoxication: a report of two cases. Renal Failure, 33(8), 837-41. https://doi.org/10.3109/0886022X.2011.599048
Wu CL, et al. Sustained Low-efficiency Daily Diafiltration With Hemoperfusion as a Therapy for Severe Star Fruit Intoxication: a Report of Two Cases. Ren Fail. 2011;33(8):837-41. PubMed PMID: 21770853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained low-efficiency daily diafiltration with hemoperfusion as a therapy for severe star fruit intoxication: a report of two cases. AU - Wu,Chia-Lin, AU - Chiu,Ping-Fang, AU - Yang,Yu, AU - Wen,Yao-Ko, AU - Chiu,Chun-Ching, AU - Chang,Chia-Chu, Y1 - 2011/07/20/ PY - 2011/7/21/entrez PY - 2011/7/21/pubmed PY - 2012/1/11/medline SP - 837 EP - 41 JF - Renal failure JO - Ren Fail VL - 33 IS - 8 N2 - Over the past decade, star fruit (Averrhoa carambola) intoxication decreased in the Taiwanese society due to improved public education on chronic kidney disease (CKD). Various complications including hiccups, altered levels of consciousness, coma, and seizures have been reported in individuals with renal failure who ingested fresh star fruit or star fruit juice. A high mortality rate (from 33 to 80%) was observed in patients with altered levels of consciousness, despite prompt dialysis and supportive care. According to previous case reports, the proposed treatment of choice for severe star fruit intoxication may be continuous renal replacement therapy with or without hemoperfusion. We report two cases of star fruit intoxication with stage V CKD (one case is predialysis) presenting with coma and generalized tonic-clonic seizures. The two patients were treated with sustained low-efficiency daily diafiltration (SLEDD-f) and charcoal hemoperfusion. Status epilepticus was controlled fairly quickly after treatment with SLEDD-f and hemoperfusion. However, the outcomes in this report are still poor (both remained comatose; one of two patients died). Currently, there are no data for the use of SLEDD-f with hemoperfusion for severe star fruit intoxication. SLEDD-f with charcoal hemoperfusion may play a role in managing refractory status epilepticus in patients with severe star fruit poisoning. SN - 1525-6049 UR - https://www.unboundmedicine.com/medline/citation/21770853/Sustained_low_efficiency_daily_diafiltration_with_hemoperfusion_as_a_therapy_for_severe_star_fruit_intoxication:_a_report_of_two_cases_ L2 - https://www.tandfonline.com/doi/full/10.3109/0886022X.2011.599048 DB - PRIME DP - Unbound Medicine ER -