Ackee Fruit Toxicity Workup

Updated: Mar 28, 2022
  • Author: Dave A Holson, MD, MBBS, MPH; Chief Editor: Stephen L Thornton, MD  more...
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Workup

Laboratory Studies

In patients with suspected ackee fruit poisoning, immediately order a fingerstick glucose test; do not wait for the serum glucose result. Profound hypoglycemia with blood glucose levels as low as 3 mg/dL has been documented. [14]

Obtain a serum chemical test to exclude electrolyte abnormalities as a consequence of the intractable vomiting. Elevated ammonia levels have also been reported.

Liver function tests demonstrate increased hepatic transaminases.

Obtain a urinalysis. In ackee fruit poisoning, results show acidosis but no ketosis. 

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Imaging Studies

Nonenhanced head CT scanning may be indicated for the exclusion of structural intracranial pathology in patients with altered mental status or new-onset seizures. Patients with hypoglycemia may present with a focal neurologic deficit. In other patients, head CT scan findings should be normal.

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Histologic Findings

Liver biopsy reveals depleted glycogen stores. Postmortem examination reveals the absence of liver glycogen and the fatty metamorphosis of the liver, kidney, and other organs.

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