Starfruit Intoxication

Made a fun diagnosis about a week or so again: starfruit intoxication! The starfruit (also called "carambola") is a star-shaped tropical fruit which is popular in southeast Asia. Interestingly, it also contains an chemical which, when ingested by individuals with kidney disease, acts as a neurotoxin. In this particular instance, a man with advanced kidney disease (but not yet on dialysis) became more and more lethargic while on vacation--he became so lethargic, in fact, that he could no longer breathe on his own and had to be intubated (placed on the breathing machine). We were called as the kidney consultants (since his kidneys weren't all too hot either) and after some sleuthing around elicited a history from his wife of possible starfruit ingestion while on vacation. He was placed on dialysis (which effectively removes the starfruit toxin) and, when the patient had completely regained his mental status (yay! a happy ending for once), he was indeed able to confirm that he had eaten some starfruit. Definitely one to save for the teaching files...