Fatal outcome after ingestion of star fruit in a severe chronic kidney disease patient

Uremic patients are often more susceptible to drug or toxin overload because their normal routes of excretion are compromised. Star fruit intoxication has been previously reported in dialysis patients but not in patients with earlier-stage chronic kidney disease (CKD; stages 1-5). A case of star fruit intoxication is reported in a patient not yet on dialysis. She presented with consciousness disturbance and tonic-clonic convulsions, evolving into refractory status epilepticus, and she eventually died despite hemoperfusion and hemodialysis treatment. The case reflects the need to advise those with later stages of CKD to avoid star fruit.