Fatal outcome after ingestion of star fruit (Averrhoa carambola) in uremicpatients

Clinical outcome of dialysis patients after eating star fruit (A verrhoa ca rambola) varies, but it may be fatal. In the past 10 years, 20 such patient s were treated in our hospital when they developed clinical symptoms after eating the fruit or drinking star fruit juice. Their initial presentations included sudden-onset limb numbness, muscle weakness, intractable hiccups, consciousness disturbance of various degrees, and seizure. No other major e vents that might be responsible for these symptoms could be identified. Eig ht patients died, including one patient with a serum creatinine level of 6. 4 mg/dL who had not yet begun dialysis, The clinical manifestations of the survivors were similar to those who died except for consciousness disturban ce and seizure, Death occurred within 5 days despite emergent hemodialysis and intensive medical care. The survivors' symptoms usually became less sev ere after supportive treatment, and these patients subsequently recovered w ithout obvious sequelae, The purpose of this article is to report that pati ents with renal failure who ingest star fruit may develop neurological symp toms and also run the risk for death in severe cases. Mortality may also oc cur in patients with chronic renal failure not yet undergoing dialysis, (C) 2000 by the National Kidney Foundation, Inc.