Jamaican vomiting sickness
ack·ee poi·son·ing
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.