Multiple organ dysfunction syndrome due to ingestion of fish gall bladder.
OBJECTIVE
To investigate changes in renal function, urine N-acetyl-beta-D-glucosaminidase enzyme (N-AG),liver function, myocardial enzymes, the pathology of renal damage and the mechanism of acute renal failure (ARF) associated with fish gall bladder poisoning.


METHODS
Eleven patients with acute fish gall bladder poisoning were consecutively admitted to our hospital from September 1997 to October 1999. Renal function, urine N-AG enzyme, liver function, and myocardial enzymes were assayed before and after treatment. One patient consented to a kidney biopsy and the pathology of renal damage was observed under light and electron microscopes.


RESULTS
All patients had multiple organ dysfunction syndrome (MODS) and 11 patients suffered from ARF. Ten patients had liver dysfunction, ten patients had poisonous myocarditis, and 8 patients had gastrointestinal dysfunction. Renal function, urine N-AG enzyme, liver function, and myocardial enzymes were significantly improved after treatment compared with those of before treatment (P < 0.05). Kidney biopsy showed that the main damage site was the proximal renal tubule. All eleven patients recovered and were discharged from the hospital.


CONCLUSIONS
Ingestion of fish gall bladder leads to kidney damage, as well as liver, heart and gastrointestinal tract injury. The mechanism of acute renal function failure is the serious tubular damage, confirming the location of kidney damage. Necrosis of the proximal tubules plays an important role in the development of ARF. Immediate hemodialysis is the most effective treatment.
Deng
Yuelin
Y
Department of Emergency, Xiangya Hospital, Central South University, Changsha 410008, China. dengylzh@cs.hn.cn
Xiao
Guilin
G
Jin
Yiqiang
Y
Luo
Xuehong
X
Meng
Xinke
X
Li
Jie
J
Ao
Zhang
Z
Xiao
Jenming
J
Zhou
Liping
L
D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D005399:Fishes; D005517:Foodborne Diseases / Q000209:etiology*; D005704:Gallbladder; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*