Heart & Lung: The Journal of Acute and Critical Care
Volume 39, Issue 5 , Pages 448-452 , September 2010

Severe encephalopathy after ingestion of star fruit juice in a patient with chronic renal failure admitted to the intensive care unit

  • Maria Auxiliadora-Martins, MD, PhD

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil
    • Corresponding Author InformationCorresponding author: Maria Auxiliadora-Martins, MD, PhD, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto–USP, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia - 2o andar, Av. Bandeirantes, 3900 - Bairro Monte Alegre, CEP 14049-900. Ribeirão Preto - SP. Brasil.
    • ,
  • Gil Cezar Alkmin Teixeira, MD

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil
    • ,
  • Graciana Soares da Silva, MD

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil
    • ,
  • Jaciara Machado Viana, MD, MS

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil
    • ,
  • Edson Antônio Nicolini, MD

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil
    • ,
  • Olindo Assis Martins-Filho, PhD

      Affiliations

    • Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brasil. Funding: Fundação de Amparo ao Ensino, Pesquisa e Assistência do Hospital das Clínicas, and Faculdade de Medicina de Ribeirão Preto-USP
    • ,
  • Anibal Basile-Filho, MD, PhD

      Affiliations

    • Centro de Terapia Intensiva (Campus), Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo–HCFMRP-USP, Ribeirão Preto, SP, Brasil

References 

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  12. Wang YC, Liu BM, Supernaw RB, Lu YH, Lee PY. Management of star fruit-induced neurotoxicity and seizures in a patient with chronic renal failure. Pharmacotherapy. 2006;26:143–146
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  16. Niticharoenpong K, Chalermsanyakorn P, Panvichian R, Kitiyakara C. Acute deterioration of renal function induced by star fruit ingestion in a patient with chronic kidney disease. J Nephrol. 2006;19:682–686
  17. Chen CL, Fang HC, Chou KJ, Wang JS, Chung HM. Acute oxalate nephropathy after ingestion of star fruit. Am J Kidney Dis. 2001;37:418–422
  18. Fang HC, Chen CL, Wang JS, Chou KJ, Chiou YS, Lee PT, et al. Acute oxalate nephropathy induced by star fruit in rats. Am J Kidney Dis. 2001;38:876–880
  19. Yap HJ, Chen YC, Fang JT, Huang CC. Star fruit: neglected but serious fruit intoxication in chronic renal failure. Dial Transplant. 2002;31:564–567
  20. Ho MP, Pai MF, Fan CD, Chang KS. Neurological manifestations induced by star fruit (Averrhoa carambola) intoxication in patients with chronic renal failure: two cases report. J Taiwan Emerg Med. 2001;3:31–36
  21. Tsai MH, Chang WN, Lui CC, Chung KJ, Hsu KT, Huang CR, et al. Status epilepticus induced by star fruit intoxication in patients with chronic renal disease. Seizure. 2005;14:521–525Epub 2005 Oct 5. Review
  22. Wang JL, Cheng CH, Wu MJ, Chen CH, Shu KH. Status epilepticus in two patients with chronic renal failure after ingestion of star fruit. Kidney Dial. 2000;12:166–169
  23. Chan YL, Ng HK, Leung CB, Yeung DKW. (31)phosphorous and single voxel proton MR spectroscopy and diffusion-weighted imaging in a case of star fruit poisoning. AJNR Am J Neuroradiol. 2002;23:1557–1560
  24. Carolino RO, Beleboni RO, Pizzo AB, Vecchio FD, Garcia-Cairasco N, Moyses-Neto M, et al. Convulsant activity and neurochemical alterations induced by a fraction obtained from fruit Averrhoa carambola (Oxalidaceae: Geraniales). Neurochem Int. 2005;46:523–531
  25. Wu CC, Denq JC, Tsai WS, Lin SH. Star fruit-induced neurotoxicity in two patients with chronic renal failure. J Med Sci (Taiwan). 2002;22:75–78
  26. Wu MY, Wu IW, Wu SS, Lin JL. Hemoperfusion as an effective alternative therapy for star fruit intoxication: a report of 2 cases. Am J Kidney Dis. 2007;49:e1–e5
  27. Chen LL, Fang JT, Lin JL. Chronic renal disease patients with severe star fruit poisoning: hemoperfusion may be an effective alternative therapy. Clin Toxicol (Phila). 2005;43:197–199

 All the authors have no conflict of interest to disclose.

PII: S0147-9563(09)00233-7

doi: 10.1016/j.hrtlng.2009.09.003

Heart & Lung: The Journal of Acute and Critical Care
Volume 39, Issue 5 , Pages 448-452 , September 2010

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