Star fruit poisonous for kidney patients

[Highwaycode]

Wednesday April 23, 2008

Star fruit can be poisonous for kidney patients

By AMANDA LEE

 

 

KUALA LUMPUR: All it takes is one fruit or 100ml of its juice and the ordinarily harmless star fruit becomes poison in a matter of hours for kidney patients.

 

University Malaya Medical Centre consultant nephrologist Prof Dr Tan Si-Yen said this was what had happened to Tang Gon Seang in China.

 

The 66-year-old, who has been suffering from a kidney ailment, was in Shenzhen visiting his son when fell into a coma on March 29 after eating star fruits.

 

 

[Highwaycode]

Brief Communication

Star fruit intoxication in uraemic patients: case series and review of the literature

K-C. Tse11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and , P-S. Yip11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and , M-F. Lam11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and , B-Y. Choy11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and , F-K. Li11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and , S-L. Lui22Division of Nephrology, Department of Medicine, University of Hong Kong, Tung Wah Hospital, Hong Kong, W-K. Lo22Division of Nephrology, Department of Medicine, University of Hong Kong, Tung Wah Hospital, Hong Kong, T-M. Chan11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and and K-N. Lai11Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and 1Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital and 2Division of Nephrology, Department of Medicine, University of Hong Kong, Tung Wah Hospital, Hong Kong

Correspondence to: K. N. Lai, Department of Medicine, University of Hong Kong, Room 411, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong. Email: [email protected]

Funding: None

 

Conflicts of interest: None

 

Abstract

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 spontan

[Highwaycode]

The culprit = Oxalic acid. + another neurotoxin (?)

 

Q: What substance in star

fruit causes this problem?

A: The tangy tartness in

star fruit comes from high levels

of oxalic acid (or oxalate).

Weakened kidneys can be

damaged if high levels of oxalate

accumulate in the organ.

But it is likely that another

toxin in star fruit is also problematic

since common foods

such as spinach contain even

greater levels of oxalic acid

and do not seem to be associated

with this severe problem.

The Brazilian researchers

think that star fruit contains a

substance toxic to nerves (a

neurotoxin). People with

healthy kidneys probably clear

this toxin from the blood

quickly and experience no

problem. Without efficient

kidney function, the combined

effect of oxalate and a neurotoxin

may deliver a double

whammy.

Q: How much star fruit

needs to be consumed to produce

toxic effects in kidney

patients?

A: As little as one half of a

fruit and less than eight ounces

of star fruit juice has caused

serious symptoms. One person

died from eating just one fruit.

Current medical treatment

for star fruit intoxication is

prompt kidney dialysis. Anyone

who experiences hiccups,

vomiting or other unusual

symptoms after eating star fruit

should seek medical attention

as soon as possible.

On the positive side, star

fruit lovers with normal kidneys

should be able to continue

enjoying the delectable

Edited April 23, 2008 by Highwaycode

[Jayzee]

Thanks for sharing, bro~

very useful.