Abstract

Objective To report a case of hypoglycemia due to Ackee fruit consumption. Methods This is a case report and brief review of literature. Results We report a patient with new onset hypoglycemia due to the consumption of the Ackee fruit. Patient is a 95-year-old Jamaican male with history of uncontrolled, insulin requiring Type 2 diabetes mellitus. He presented with new onset of hypoglycemia and improvement in hemoglobin A1C without any changes in diabetes regimen, other medications or co-morbidities. On investigative questioning, he reported that he had recently received a jar of preserved Ackee fruit, and was consuming small portions of it daily. This coincided with the development of hypoglycemia. Conclusion Despite being uncommonly used in the United States, Ackee fruit consumption is a known cause of hypoglycemia. Ackee fruit contains two toxins, hypoglycin A and hypoglycin B that work through the same mechanism to deplete hepatic glycogen stores and cause refractory hypoglycemia. The most severe form of Ackee-fruit toxicity is known as "Jamaican Vomiting Sickness". The disorder is characterized by symptoms of severe hypoglycemia and seizures, ultimately leading to coma and death. Although rare in the United States, it is important to understand and recognize the symptoms of Ackee fruit induced toxicity to avoid late detection and severe complications.

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