Jamaican vomiting sickness


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ack·ee poi·son·ing

an acute and frequently fatal vomiting disease associated with central nervous system symptoms and marked hypoglycemia, caused by eating unripe ackee fruit of Blighia spaida, a tree common in Jamaica.

Jamaican vomiting sickness

An intoxication by “bush tea” made from unripe fruit of the Jamaican ackee tree (Blighia sapida), which is caused by hypoglycin, a propionic acid derivative that inhibits isovaleryl CoA dehydrogenase, provoking violent vomiting, prostration, drowsiness, convulsions and hypoglycaemia as low as 0.56 mmol/L (US: 10 mg/dl).
 
Mortality
High; death often occurs within 24 hours of ingestion.
 
Pathogenesis
The condition is caused by the metabolites of hypoglycin A, an amino acid that is converted to coenzyme A thioesters and carnitine derivatives; these sequester intracellular carnitine and inhibit fatty acid oxidation, causing accumulation of isovaleric acid with continued fatty acid esterification, resulting in fine-droplet fatty liver.

Jamaican vomiting sickness

An intoxication by 'bush tea,' made from unripe fruit of the Jamaican ackee tree–Blighia sapida and Crotalaria spectabilis, caused by hypoglycin A metabolites Clinical Violent vomiting, prostration, drowsiness, convulsions, hypoglycemia Mortality High, often 24 hrs after ingestion