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Nephrology Dialysis Transplantation, Vol 13, Issue 3 570-572, Copyright © 1998 by Oxford University Press

DIALYSIS AND TRANSPLANTATION NEWS

Intoxication by star fruit (Averrhoa carambola) in six dialysis patients? (Preliminary report)

M Neto, F Robl and J Netto
Nephrology Divisions: Hospital das Clinica`s of the Ribeirao Preto Faculty of Medicine, University of Sao Paulo Nd Hospital Sao Francisco, Brazil; Biochemistry Department of the Ribeirao Preto Faculty of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil; Corresponding author at: Rua Maria Quiteria 342, 14025-320 Ribeirao Preto, SP, Brazil

We observed six cases of patients in a dialysis programme who were apparently intoxicated by ingestion of star fruit. After ingestion of 2-3 fruits or 150-200 ml of the fruit juice, the six patients, who had previously been stable in a regular dialysis programme, developed a variety of symptoms ranging from insomnia and hiccups to agitation, mental confusion and (in one case) death. In preliminary investigations to characterize the hypothetical neurotoxin in the fruit, an extract, when injected intraperitoneally or intracerebroventricularly in rats, provoked persistent convulsions of the tonic-clinic type. It appears that star fruit (Averrhoa carambola) contains an excitatory neurotoxin. Patients with renal failure on conservative or dialysis treatment should be dissuaded from ingestion of the fruit.
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