Open AccessAcute kidney injury with neurological features: Beware of the star fruit and its caramboxin
Author(s) -
Matheo Augusto Morandi Stumpf,
Adriana Fátima Menegat Schuinski,
Gilberto Baroni,
Maikel Ramthun
Publication year - 2020
Publication title -
indian journal of nephrology/indian journal of nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 24
eISSN - 1998-3662
pISSN - 0971-4065
DOI - 10.4103/ijn.ijn_53_19
Subject(s) - medicine , acute kidney injury , stroke (engine) , paresis , dialysis , renal biopsy , nephropathy , kidney , renal function , diabetes mellitus , surgery , endocrinology , engineering , mechanical engineering
Star fruit (Averrhoa carambola) is a well-known product in tropical countries. There are few reports published in literature with acute kidney injury due to oxalate induced nephropathy. However, none of them have an important neurological feature. We present a case of a 51-year-old male with paresis and altered mental status. Screening for neurological diseases such as stroke, Guillain-Barre, meningitis and encephalitis were negative. In the evolution, he developed acute kidney failure and was submitted to 4 dialysis sessions. After talking to the family, we discovered he had ingested over 50 star fruits prior to the acute neurologic deficits. He recovered renal function so a renal biopsy was not required. Physicians should actively look for star fruit ingestion history in patients presenting with unexplained acute kidney injury with or without neurological features. Besides, taking star fruit in a large amount, accompanied by an empty stomach and dehydrated state, is a risk factor for neurotoxicity.