Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait. (8th October 2012)

• Record Type: Journal Article
• Authors: Grunes, Dianne E.; Scordi-Bello, Irini; Suh, Matthew; Florman, Sander; Yao, Jonathan; Fiel, Maria Isabel; Thung, Swan N.
• Other Names: Betjes M. G. H. Academic Editor.; Keller F. Academic Editor.
• Is Part Of: Case reports in transplantation. Volume 2012(2012)
• Publication Date: 2012-10-08
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation; Transplantation of organs, tissues, etc; Periodicals; Periodicals; 617.954
• DOI: 10.1155/2012/739238
• Languages: English
• ISSNs: 2090-6943

Abstract

Abstract : We report a case of fulminant liver failure resulting in emergent liver transplantation following 3 weeks of nausea, vomiting, and malaise from Jamaican Vomiting Sickness. Jamaican Vomiting Sickness is caused by ingestion of the unripe arils of the Ackee fruit, its seeds and husks. It is characterized by acute gastrointestinal illness and hypoglycemia. In severe cases, central nervous system depression can occur. In previous studies, histologic sections taken from patients with Jamaican Vomiting Sickness have shown hepatotoxicity similar to that seen in Reye syndrome and/or acetaminophen toxicity. We highlight macroscopic and microscopic changes in the liver secondary to hepatoxicity of Ackee fruit versus those caused by a previously unknown sickle cell trait. We discuss the clinical variables and the synergistic hepatotoxic effect of Ackee fruit and ischemic injury from sickled red blood cells, causing massive hepatic necrosis in this patient.