Zhou Li-Na, Dong Shao-Shao, Zhang Sheng-Ze, Huang Wen
Department of Nephrology, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang Province, China.
Department of Nephrology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
World J Clin Cases. 2021 Feb 6;9(4):943-950. doi: 10.12998/wjcc.v9.i4.943.
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.
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.
Physicians should be mindful of toxic complications of raw grass carp gallbladder ingestion and we should promote awareness to reduce incidences of food poisoning.
在亚洲国家,鱼胆长期以来一直被用作民间药物。我们已经知道,摄入鱼胆后会导致多器官损伤,甚至危及生命。在此,我们描述一例因草鱼胆中毒导致的急性肾衰竭(ARF)和肝炎病例,并对相关文献进行综述。
一名50岁的既往健康女性因试图缓解咳嗽而摄入两个生草鱼胆后,出现2天的全腹痛和反复呕吐,被收治入院。第4天出现无尿,血清肌酐、尿素、胆红素、丙氨酸转氨酶和天冬氨酸转氨酶显著升高。通过对其病史的全面评估和及时的生化检查,我们诊断她为鱼胆中毒继发的急性肾衰竭和肝炎。她的肾活检显示急性肾小管坏死,随后因肾衰竭接受了6次常规血液透析。给予胃黏膜保护剂和肝保护剂进行支持治疗,以保护靶器官。患者的肝功能逐渐恢复,第24天出院时血清肌酐为164 mmol/L。在2周的随访期内,她的肾功能完全恢复。
医生应注意生草鱼胆摄入的毒性并发症,我们应提高认识以减少食物中毒的发生率。