2006-12-30
Starfruit's toxin
Starfruit ( i.e. carambola) is a known kidney toxin. Star fruit originated in Southeast Asia and is readily available in Taiwan. Star fruit causes several symptoms in patients with chronic renal failure or end-stage renal disease. The symptoms vary and include insomnia, intractable hiccups, agitation, muscle weakness, confusion, consciousness disturbances of various degrees, seizures, and cardiorespiratory arrest. The various star fruit subspecies contain different toxins, including a powerful neurotoxin that is suspected to accumulate in blood, cross the blood-brain barrier in chronic renal failure patients, and eventually cause irreversible damage.
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食用楊桃可能出現中毒
14- 06- 2006
腎病患者吃楊桃中毒命危
【成報綜合報道】學者發現楊桃對腎臟具有損害作用，包括導致血尿、蛋白尿、腎病綜合症，甚至急性腎功能衰竭。深圳一位身患尿毒症的70歲老人因食楊桃，竟然深度昏迷10天，生命垂危，經全力搶救，才起死回生。
老翁周一從深圳市第二人民醫院出院，這是該院首次發現患者吃楊桃中毒病例。患者本身患有尿毒症，食用楊桃數小時後出現「頑固性呃逆」，相繼出現嗜睡、深度昏迷，生命一度垂危。該院腎內科主任何永成博士表示，楊桃對於健康人是可口的美食，但對於腎病患者尤其是腎衰竭患者卻可能是「毒物」。
健康人食用楊桃無不良反應，但已患有腎臟病尤其是腎功能衰竭的病人食用楊桃則可能出現中毒。
何永成博士亦表示，楊桃成分與其他水果無太多區別，其毒性成分尚待進一步深入研究。不過腎臟病患者如食用要特別小心。
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Kidney patients
should avoid star fruit
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Star fruit is a decorative and refreshing treat and, for most of us, a healthy delicacy. But for some people with impaired kidney function, the star fruit (also known as carambola) can be deadly.
Researchers from Brazil and Taiwan are studying why star fruit causes serious life-threatening reactions to some kidney patients.
Question: What are the symptoms of star fruit intoxication?
Answer: Typical symptoms occur within one to five hours and include persistent hiccups, nausea, vomiting, agitation, insomnia, mental confusion and convulsions. Death sometimes results. A study conducted at the University of Sao Paulo found that hiccups were experienced in 30 of 32 cases, and vomiting in about two-thirds. Even though mental confusion and convulsions were less common, these symptoms are more likely to be associated with death.
Q: Does star fruit cause kidney problems?
A: No. Star fruit intoxication only occurred if some degree of kidney failure already existed. For most of those affected, kidney decline was extensive enough that they were being treated by blood dialysis, although in four cases kidney problems had not reached that severity. There is no evidence of any problem for people with normal kidney function.
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 treat without concern.
Health Events
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Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S. are
nutritionists in the Department of Human Nutrition, Food and Animal
Sciences, College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Services and prepares
the nutritional analyses
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