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Zhou LN, Dong SS, Zhang SZ, Huang W. Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report. World J Clin Cases 2021; 9:943-950. [PMID: 33585643 PMCID: PMC7852650 DOI: 10.12998/wjcc.v9.i4.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/18/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fish gallbladder has long been used as a folk remedy in Asian countries. Multiple organ damage after ingestion of fish gallbladder resulting in near mortality has been known to us. Here, we describe a case of acute renal failure (ARF) and hepatitis due to grass carp gallbladder poisoning and review the literature.
CASE SUMMARY A previously healthy, 50-year-old woman was admitted to our hospital with a 2-d history of generalized abdominal pain and repeated vomiting following ingestion of two raw grass carp gallbladders in an attempt to alleviate her cough. She developed anuria on day 4 with markedly elevated serum creatinine, urea, bilirubin, alanine aminotransferase, and aspartate aminotransferase. Based on thorough evaluation of her history and prompt biochemical investigations, we diagnosed her with ARF and hepatitis secondary to fish gallbladder poisoning. Her renal biopsy revealed acute tubular necrosis, following which she underwent six sessions of conventional hemodialysis due to renal failure. Supportive treatment with gastric mucosal protectant and liver protectant was administered for targeted organ protection. The patient’s liver function gradually recovered, and serum creatinine was 164 mmol/L at discharge on day 24. Over a follow-up period of 2 wk, her renal function completely recovered.
CONCLUSION Physicians should be mindful of toxic complications of raw grass carp gallbladder ingestion and we should promote awareness to reduce incidences of food poisoning.
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Affiliation(s)
- Li-Na Zhou
- Department of Nephrology, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Shao-Shao Dong
- Department of Nephrology, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Sheng-Ze Zhang
- Department of Nephrology, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Wen Huang
- Department of Nephrology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Lin L, Sandefur BJ, Campbell RL, Liu Z, Liu XW. Biphasic anaphylaxis manifested as type I Kounis syndrome induced by ingestion of raw fish gallbladder: A case report. World J Emerg Med 2021; 12:238-240. [PMID: 34141043 DOI: 10.5847/wjem.j.1920-8642.2021.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Long Lin
- Department of Emergency Medicine, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
| | | | - Ronna L Campbell
- Department of Emergency Medicine, Mayo Clinic, Rochester 55905, USA
| | - Zhi Liu
- Department of Emergency Medicine, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
| | - Xiao-Wei Liu
- Department of Emergency Medicine, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
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3
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Yan W, Wang Z, Lu S, Li J, Chen Q, Wang L, Chen S, Wang X, Xiong K, Yan J. Analysis of factors related to prognosis and death of fish bile poisoning in China: A retrospective study. Basic Clin Pharmacol Toxicol 2020; 127:419-428. [PMID: 32441465 DOI: 10.1111/bcpt.13447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/19/2020] [Indexed: 01/25/2023]
Abstract
Fish bile has long been considered to have therapeutic benefits in folk medicine in some Asian countries. However, poisoning incidents and even death sporadically occurred when people consumed fish bile. Herein, we summarize the main characteristics of fish bile poisoning in China including clinical symptoms, treatment strategies and factors being associated with death and affecting prognosis, hoping to provide a reference for the diagnosis and treatment of fish bile poisoning, as well as forensic identification of death cases induced by fish bile poisoning. We suggest that the health authorities should make an effort to enhance people's awareness of the safety of traditional medicine like fish bile so as to reduce the incidence of adverse events.
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Affiliation(s)
- Weitao Yan
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China.,Department of Neurobiology and Human Anatomy, School of Basic Medical Science, Central South University, Changsha, China
| | - Zhen Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Shuang Lu
- Department of Neurobiology and Human Anatomy, School of Basic Medical Science, Central South University, Changsha, China
| | - Jingyu Li
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China
| | - Qianqian Chen
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China
| | - Lan Wang
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China
| | - Siqi Chen
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China
| | - Xiao Wang
- Urumqi General Hospital of Xinjiang Military Region, Urumqi, China
| | - Kun Xiong
- Department of Neurobiology and Human Anatomy, School of Basic Medical Science, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Jie Yan
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, China
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Rudiansyah M, Lubis L, Bandiara R, Supriyadi R, Afiatin, Gondodiputro RS, Roesli RMA, Rachmadi D. Java Barb Fish Gallbladder-Induced Acute Kidney Injury and Ischemic Acute Hepatic Failure. Kidney Int Rep 2020; 5:751-753. [PMID: 32405599 PMCID: PMC7210697 DOI: 10.1016/j.ekir.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/02/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mohammad Rudiansyah
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin Hospital Banjarmasin, Indonesia.,Postgraduate Doctoral Program, Faculty of Medicine, Universitas Padjadjaran Bandung, Indonesia
| | - Leonardo Lubis
- Department of Anatomy, Physiology and Cell Biology, Faculty of Medicine, Universitas Padjadjaran Bandung, Indonesia
| | - Ria Bandiara
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
| | - Rudi Supriyadi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
| | - Afiatin
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
| | - Rubin Surachno Gondodiputro
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
| | - Rully Marsis Amirullah Roesli
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
| | - Dedi Rachmadi
- Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital Bandung, Indonesia
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Chow HC, So TH, Choi HCW, Lam KO. Literature Review of Traditional Chinese Medicine Herbs-Induced Liver Injury From an Oncological Perspective With RUCAM. Integr Cancer Ther 2020; 18:1534735419869479. [PMID: 31405304 PMCID: PMC6693029 DOI: 10.1177/1534735419869479] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Traditional Chinese medicine (TCM) herbs are commonly regarded to be safe with
minimal toxicities in Chinese communities. Cancer patients who are receiving
Western oncology therapy often concurrently take TCM herbs for anticancer and
symptom relief purposes. We performed a literature review for current evidence
on TCM herb–induced liver injury from an oncological perspective. A literature
search on PubMed was performed to identify publications regarding TCM herbs and
concoctions with hepatoprotective or hepatotoxic properties. Lists of commonly
used herbs and their causality levels were compiled. In view of the wide range
of evidence available, cases assessed by the well-established RUCAM (Roussel
Uclaf Causality Assessment Method) algorithm were categorized as the highest
level of evidence. More than one case of TCM herb–induced liver injury was
confirmed by RUCAM in the following herbs and concoctions: Lu Cha
(Camellia sinensis), Bai Xian Pi (Dictamnus
dasycarpus), Tu San Qi (Gynura segetum), Jin Bu
Huan (Lycopodium serratum), He Shou Wu (Polygoni
multiflora), Ge Gen (Pueraria lobata), Dan Lu Tong
Du tablet, Shou Wu Pian, Xiao Chai Hu Tang, Xiao Yin pill, and Yang Xue Sheng Fa
capsule. Finally, TCM with anticancer or symptom relief uses were discussed in
detail with regard to their hepatotoxic or hepatoprotective properties.
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Affiliation(s)
- Hei Ching Chow
- 1 Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Tsz Him So
- 1 Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Horace Cheuk Wai Choi
- 1 Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ka On Lam
- 1 Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Continuous Renal Replacement Therapy for Multiple Organ Injury Induced by Raw Fish Gallbladder Poisoning. Am J Ther 2019; 24:e773-e774. [PMID: 27574936 DOI: 10.1097/mjt.0000000000000491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Brown AC. Kidney toxicity related to herbs and dietary supplements: Online table of case reports. Part 3 of 5 series. Food Chem Toxicol 2018; 107:502-519. [PMID: 28755953 DOI: 10.1016/j.fct.2016.07.024] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/30/2016] [Accepted: 07/22/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND No tabular summary of potentially life-threatening, kidney-toxic dietary supplements (DS; includes herbs) based on PubMed case reports is currently available online and continually updated to forewarn United States consumers, clinicians, and companies manufacturing DS. The purpose of this review was to create an online research summary table of kidney toxicity case reports related to DS. METHODS Documented PubMed case reports (1966 to May 2016, and cross-referencing) of DS appearing to contribute to kidney toxicity were listed in "DS Toxic Tables." Keywords included "herb" or "dietary supplement" combined with "kidney" to generate an overview list, and possibly "toxicity" to narrow the selection. Case reports were excluded if they involved herb combinations (some exceptions), Chinese herb mixtures, teas of mixed herb contents, mushrooms, poisonous plants, self-harm, excessive doses (except vitamins/minerals), legal or illegal drugs, drug-herbal interactions, and confounders of drugs or diseases. Since commercial DS often include a combination of ingredients, they were treated separately; so were foods. A few foods with kidney-toxic effects were listed in a fourth table. The spectrum of herbal or DS-induced kidney injuries included kidney stones, nephritis, nephrotic syndrome, necrosis, acute kidney injury (AKI; previously known as acute renal failure [ARF]), chronic kidney disease, kidney transplant, and death. RESULTS Approximately 7 herbs (minus 4 no longer for sale) and 10 dietary supplements (minus 3 excluded due to excessive doses + germanium that is no longer sold) have been related to kidney injury case reports published in PubMed (+crosslisting) in the last 50 + years (1966 to May 2016). The implicated herbs include Chinese yew (Taxus celbica) extract, impila (Callilepis laureola), morning cypress (Cupressus funebris Endl), St. John's wort (Hypericum perforatum), thundergod vine (Tripterygium wilfordii hook F), tribulus (Tribulus terrestris) and wormwood (Artemisia herba-alba). No longer sold in the United States are chocolate vine or mu tong (Caulis aristolochiae), guang fang ji (Aristolochia fangchi), ma huang (Ephedra sinica), and Tenshin Tokishigyaku-ka-goshuyu-shokyo-to. The DS include bile (sheep), chlorella, chromium (Cr), CKLS, creatine, gallbladder (fish), glucosamine, hydrazine, N.O.-Xplode, Spanish fly, and excess intakes of vitamins A, C, and D. Germanium (Ge) is not available for sale. The top two DS with the largest number of reported publications, but not always case reports, in descending order, were the aristolochic acid-containing herbs guang fang ji (mistaken identity) and chocolate vine or mu tong. The remaining DS featured one to three publications over a 50+ year period. Numerous case reports were reported for kidney-toxic foods: djenkol bean, gallbladders (carp fish, pufferfish, & snake), and star fruit (only in chronic kidney disease patients), and uncooked yam powder or juice. CONCLUSION This online "DS Toxic Table" provides clinicians, consumers, and manufacturers with a list of herbs that could potentially contribute to kidney injuries.
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Affiliation(s)
- Amy Christine Brown
- Department of Complementary and Alternative Medicine, John A. Burns School of Medicine, 651 Ilalo Street, MEB 223, Honolulu, HI, USA; University of Hawaii at Manoa, Honolulu, HI, USA.
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Abstract
Objective To report the poisoning data of Hong Kong Poison Information Centre (HKPIC) in 2007. Methods From 1st January 2007 to 31st December 2007, all poisoning cases received by HKPIC were retrieved from its database (DATOX) for analysis. Results 2842 poisoned cases were analyzed. There were 1199 male and 1610 female patients and more than two-thirds of the cases were between 20 and 59 years old. Common causes of exposure were suicidal attempt, accident and abusive use. Non-benzodiazepine sedative-hypnotic, household products and paracetamol were common poisons exposed. The majority of the patients were managed conservatively, with 8.4% and 6.4% treated by decontamination and antidotes respectively. Most cases had uneventful recovery; less than 1% of the poison exposure resulted in death and about 5% of the exposure had major outcomes. Conclusions This 2007 annual report provided updated epidemiological information on the poisoning pattern in Hong Kong and highlighted some changes in comparison to the situation in 2006.
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Yuan FH, Hou WP, Wang DH, Du X, Guang LX, Zhang Y, Pang F. Clinical analysis of 156 cases of multiple organ failure caused by fish bile. Toxicol Rep 2015; 2:1194-1199. [PMID: 28962461 PMCID: PMC5598367 DOI: 10.1016/j.toxrep.2015.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/17/2015] [Accepted: 08/17/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To analyze the clinical features and prognosis of patients suffering from fish bile poisoning. METHODS A total of 156 multiple organ failure (MOF) patients caused by fish bile poisoning were hospitalized in our department over the past 28 years. The patients' symptoms, examination results, treatment and outcomes were collected and analyzed. RESULTS All patients' first symptom was gastrointestinal discomfort, including unbearable nausea and intractable vomiting. The symptoms that followed were oliguria or anuria, edema, headache, fatigue, jaundice, palpitation, alimentary tract hemorrhage, gross hematuria, dyspnea, shock, tachycardia, bradycardia, arrhythmia, coma, and cardiac arrest. The symptom severity and cohort were different among different patients. Twenty-one cases received gastroscopy, which exhibited diffuse gastric mucosal bleeding. Twelve patients received renal biopsy, which exhibited focal necrosis of tubular epithelial cells. One patient received a liver biopsy, which exhibited extensive hepatocyte necrosis. All patients received blood purification therapy. Of the four patients who died, 4 out of 5 organs had failed. The general mortality rate was 2.6%. CONCLUSIONS Compared with the MOF caused by trauma and sepsis, the fish bile poisoning MOF has a much lower morality rate. However, patients with higher age, more underlying diseases, and more organ failure tended to have a worse prognosis.
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Affiliation(s)
- Fa-Huan Yuan
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Wei-Ping Hou
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Dai-Hong Wang
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Xiang Du
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Li-Xia Guang
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Ying Zhang
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Fang Pang
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
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11
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Teschke R. Traditional Chinese Medicine Induced Liver Injury. J Clin Transl Hepatol 2014; 2:80-94. [PMID: 26357619 PMCID: PMC4521264 DOI: 10.14218/jcth.2014.00003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 02/27/2014] [Accepted: 03/02/2014] [Indexed: 12/12/2022] Open
Abstract
Traditional Chinese Medicine (TCM) is popular around the world and encompasses many different practices with particular emphasis on herbal TCM. Using the PubMed database, a literature search was undertaken to assess the extent herbal TCM products exert rare hepatotoxicity. Analysis of reported cases revealed numerous specified herbal TCM products with potential hepatotoxicity. Among these were An Shu Ling, Bai Fang, Bai Xian Pi, Ban Tu Wan, Bo He, Bo Ye Qing Niu Dan, Bofu Tsu Sho San, Boh Gol Zhee, Cang Er Zi, Chai Hu, Chaso, Chi R Yun, Chuan Lian Zi, Ci Wu Jia, Da Chai Hu Tang, Da Huang, Du Huo, Gan Cao, Ge Gen, Ho Shou Wu, Hu Bohe You, Hu Zhang, Huang Qin, Huang Yao Zi, Hwang Geun Cho, Ji Gu Cao, Ji Ji, Ji Xue Cao, Jiguja, Jin Bu Huan, Jue Ming Zi, Kamishoyosan, Kudzu, Lei Gong Teng, Long Dan Xie Gan Tang, Lu Cha, Ma Huang, Mao Guo Tian Jie Cai, Onshido, Polygonum multiflorum, Qian Li Guang, Ren Shen, Sairei To, Shan Chi, Shen Min, Shi Can, Shi Liu Pi, Shou Wu Pian, Tian Hua Fen, White flood, Wu Bei Zi, Xi Shu, Xiao Chai Hu Tang, Yin Chen Hao, Zexie, Zhen Chu Cao, and various unclassified Chinese herbal mixtures. Causality was firmly established for a number of herbal TCM products by a positive reexposure test result, the liver specific scale of CIOMS (Council for International Organizations of Medical Sciences), or both. Otherwise, the quality of case data was mixed, especially regarding analysis of the herb ingredients because of adulteration with synthetic drugs, contamination with heavy metals, and misidentification. In addition, non-herbal TCM elements derived from Agaricus blazei, Agkistrodon, Antelope, Bombyx, Carp, Fish gallbladder, Phellinus, Scolopendra, Scorpio, and Zaocys are also known or potential hepatotoxins. For some patients, the clinical course was severe, with risks for acute liver failure, liver transplantation requirement, and lethality. In conclusion, the use of few herbal TCM products may rarely be associated with hepatotoxicity in some susceptible individuals, necessitating a stringent pretreatment evaluation of the risk/benefit ratio, based on results of multicenter, randomized, double-blind, placebo-controlled clinical trials.
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Affiliation(s)
- Rolf Teschke
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/ Main, Germany
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Food poisonings by ingestion of cyprinid fish. Toxins (Basel) 2014; 6:539-55. [PMID: 24476713 PMCID: PMC3942750 DOI: 10.3390/toxins6020539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 12/17/2022] Open
Abstract
Raw or dried gallbladders of cyprinid fish have long been ingested as a traditional medicine in the Asian countries, particularly in China, for ameliorating visual acuity, rheumatism, and general health; however, sporadic poisoning incidences have occurred after their ingestion. The poisoning causes complex symptoms in patients, including acute renal failure, liver dysfunction, paralysis, and convulsions of limbs. The causative substance for the poisoning was isolated, and its basic properties were examined. The purified toxin revealed a minimum lethal dose of 2.6 mg/20 g in mouse, when injected intraperitoneally. The main symptoms were paralysis and convulsions of the hind legs, along with other neurological signs. Liver biopsy of the euthanized mice clearly exhibited hepatocytes necrosis and infiltration of neutrophils and lymphocytes, suggesting the acute dysfunction of the liver. Blood tests disclosed the characteristics of acute renal failure and liver injury. Infrared (IR) spectrometry, fast atom bombardment (FAB) mass spectrometry, and 1H- and 13C-nuclear magnetic resonance (NMR) analysis indicated, a molecular formula of C27H48O8S, containing a sulfate ester group for the toxin. Thus, we concluded that the structure of carp toxin to be 5α-cyprinol sulfate (5α-cholestane-3α, 7α, 12α, 26, 27-pentol 26-sulfate). This indicated that carp toxin is a nephro- and hepato- toxin, which could be the responsible toxin for carp bile poisoning in humans.
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Chen L, Huang GZ. Poisoning by toxic animals in China—18 autopsy case studies and a comprehensive literature review. Forensic Sci Int 2013; 232:e12-23. [DOI: 10.1016/j.forsciint.2013.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 07/26/2013] [Accepted: 08/09/2013] [Indexed: 01/25/2023]
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Luyckx VA. Nephrotoxicity of alternative medicine practice. Adv Chronic Kidney Dis 2012; 19:129-41. [PMID: 22578672 DOI: 10.1053/j.ackd.2012.04.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 04/06/2012] [Accepted: 04/09/2012] [Indexed: 11/11/2022]
Abstract
The use of alternative medicine is highly prevalent around the world; in many areas, this is so because of lack of access to, or trust in, Western medicine, and also because they are considered "natural" and therefore safe. The kidney is an organ vulnerable to toxic insults by virtue of its anatomy and function. Reports of nephrotoxicity associated with alternative medicine use encompass all forms of renal dysfunction, ranging from electrolyte abnormalities and proteinuria to acute and CKD, renal failure, and death. In countries where intensive care and dialysis support are not available, mortality is high. Mechanisms of alternative medicine-associated kidney injury include direct nephrotoxicity, which may be augmented by underlying predisposing conditions such as dehydration; contamination, or adulteration of remedies; inappropriate use or preparation of a remedy; or interactions with other medications. The use of alternative medicines is underreported to clinicians. Because many patients strongly believe in the powers of alternative medicines, it is important that alternative medicines not be demonized as a whole, but that their use and consequences be closely observed and reported to build a more comprehensive understanding of their impact in our clinical practice and to foster research on the potential harm or, in some cases, possible benefits.
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Inhibition of mitochondrial respiratory chain in the brain of rats after hepatic failure induced by carbon tetrachloride is reversed by antioxidants. Brain Res Bull 2009; 80:75-8. [PMID: 19406217 DOI: 10.1016/j.brainresbull.2009.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 04/21/2009] [Accepted: 04/22/2009] [Indexed: 11/23/2022]
Abstract
Hepatic encephalopathy is an important cause of morbidity and mortality in patients with severe hepatic failure. This disease is clinically characterized by a large variety of symptoms including motor symptoms, cognitive deficits, as well as changes in the level of alertness up to hepatic coma. Carbon tetrachloride is frequently used in animals to produce an experimental model to study the mechanisms involved in the progression of hepatic disease and the impact of various drugs on this progression. The brain is highly dependent on ATP and most cell energy is obtained through oxidative phosphorylation, a process requiring the action of various respiratory enzyme complexes located in a special structure of the inner mitochondrial membrane. In this context, we evaluated the activities of mitochondrial respiratory chain complexes in the brain of rats submitted to acute administration of carbon tetrachloride and treated with NAC and DFX alone or in combination. Our results showed that complexes I, II and IV were inhibited after carbon tetrachloride administration and that NAC and DFX alone or in combination were able to prevent the inhibition of these enzymes. On the other hand, complex III was not affected. The participation of oxidative stress has been postulated in the hepatic encephalopathy and it is well known that the electron transport chain itself is vulnerable to damage by this species. Based on our findings, we suggest that oxidative stress may be involved in the inhibition of complexes from mitochondrial respiratory chain.
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