Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2021; 9(4): 943-950
Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.943
Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report
Li-Na Zhou, Shao-Shao Dong, Sheng-Ze Zhang, Wen Huang
Li-Na Zhou, Shao-Shao Dong, Sheng-Ze Zhang, Department of Nephrology, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang Province, China
Wen Huang, Department of Nephrology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Zhou LN wrote the article; Dong SS performed renal biopsy and conventional hemodialysis on the patient; Zhang SZ collected the data; Huang W approved the final version of the manuscript.
Informed consent statement: The Ethics Committee of Wenzhou People's Hospital approved the publication of this report. Informed consent was obtained from the patient for the publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen Huang, MD, Doctor, Department of Nephrology, The Second Affiliated Hospital of Wenzhou Medical University, No. 108 College Road, Wenzhou 325000, Zhejiang Province, China. 207071@wzhealth.com
Received: October 7, 2020
Peer-review started: October 7, 2020
First decision: November 14, 2020
Revised: November 18, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: February 6, 2021
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Physicians should be mindful of toxic complications of raw grass carp gallbladder ingestion and we should promote awareness to reduce incidences of food poisoning.

Keywords: Grass carp gallbladder, Case report, Acute renal failure, Hepatitis, Ichthyogallotoxin, Hemodialysis

Core Tip: We describe the clinical presentation of a patient who suffered acute renal and hepatic insult following ingestion of raw carp gallbladder. To our knowledge, cardiac and hematological effects of this toxicity have never been reported before. We believe that this paper will be of interest because ingestion of raw gallbladder is a common practice in rural southern and southeastern Asia, and with global travel becoming more prevalent, knowledge on this clinical scenario will benefit physicians all worldwide.