Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait
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 characteriz...
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Hindawi Limited
2012-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2012/739238 |
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doaj-24bd6d63ee864e2abdf807e4d026aeca2020-11-25T01:10:31ZengHindawi LimitedCase Reports in Transplantation2090-69432090-69512012-01-01201210.1155/2012/739238739238Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell TraitDianne E. Grunes0Irini Scordi-Bello1Matthew Suh2Sander Florman3Jonathan Yao4Maria Isabel Fiel5Swan N. Thung6Department of Pathology, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USAOffice of the Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USADepartment of Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USADepartment of Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USADepartment of Pathology, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USADepartment of Pathology, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USADepartment of Pathology, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1194, New York, NY 10029, USAWe 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.http://dx.doi.org/10.1155/2012/739238 |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Dianne E. Grunes Irini Scordi-Bello Matthew Suh Sander Florman Jonathan Yao Maria Isabel Fiel Swan N. Thung |
| spellingShingle |
Dianne E. Grunes Irini Scordi-Bello Matthew Suh Sander Florman Jonathan Yao Maria Isabel Fiel Swan N. Thung Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait Case Reports in Transplantation |
| author_facet |
Dianne E. Grunes Irini Scordi-Bello Matthew Suh Sander Florman Jonathan Yao Maria Isabel Fiel Swan N. Thung |
| author_sort |
Dianne E. Grunes |
| title |
Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait |
| title_short |
Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait |
| title_full |
Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait |
| title_fullStr |
Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait |
| title_full_unstemmed |
Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait |
| title_sort |
fulminant hepatic failure attributed to ackee fruit ingestion in a patient with sickle cell trait |
| publisher |
Hindawi Limited |
| series |
Case Reports in Transplantation |
| issn |
2090-6943 2090-6951 |
| publishDate |
2012-01-01 |
| description |
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. |
| url |
http://dx.doi.org/10.1155/2012/739238 |
| work_keys_str_mv |
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