Park S K, Kim D G, Kang S K, Han J S, Kim S G, Lee J S, Kim M C
Department of Internal Medicine, Chonbuk, Korea.
Nephron. 1990;56(2):188-93. doi: 10.1159/000186131.
The raw carp bile has both nephrotoxic and hepatotoxic effects which are not well known. Recently, we studied 13 patients who had toxic acute renal failure and toxic hepatitis after ingestion of raw bile of carp in 3, grass carp in 8 and silver carp in 2 cases. The purpose of this report is to alert physicians to this very rare cause of toxic acute renal failure and hepatitis. All patients presented initially with gastrointestinal upset after eating. These symptoms were followed by oliguria in 7 patients (54%), hematuria was noted in 10 (77%) and jaundice in 8 patients (62%). Elevation of blood urea nitrogen, creatinine and transaminases lasted for about 3 weeks. The severity of the symptoms depended on the amount of bile ingested. All the patients recovered with conservative therapy and hemodialysis. Biopsy of the kidney revealed findings compatible with acute tubular necrosis similar to that produced by other nephrotoxins. Biopsy of the liver revealed findings consistent with acute toxic hepatitis. Both suggest toxic effects of carp bile as a cause of toxic acute renal failure and hepatitis.
生鲤鱼胆汁具有肾毒性和肝毒性，而这一点尚不为人熟知。最近，我们研究了13例患者，其中3例因摄入生鲤鱼胆汁、8例因摄入生草鱼胆汁、2例因摄入生鲢鱼胆汁后出现中毒性急性肾衰竭和中毒性肝炎。本报告的目的是提醒医生注意这种极为罕见的中毒性急性肾衰竭和肝炎的病因。所有患者最初在进食后均出现胃肠道不适。随后，7例患者（54%）出现少尿，10例（77%）出现血尿，8例患者（62%）出现黄疸。血尿素氮、肌酐和转氨酶升高持续约3周。症状的严重程度取决于摄入胆汁的量。所有患者经保守治疗和血液透析后均康复。肾脏活检显示的结果与其他肾毒素所致的急性肾小管坏死相符。肝脏活检显示的结果与急性中毒性肝炎一致。两者均提示鲤鱼胆汁的毒性作用是中毒性急性肾衰竭和肝炎的病因。
