KEMAL TOLGA SARAÇOĞLU, AYTEN SARAÇOĞLU, Özgür ERDÖNMEZ

Severe cachexia and prolonged stay in the intensive care unit following ingestion of caigua

Güney Amerika’da yaygın olarak yetişen ve kullanılan tropikal bir bitki olan Caigua (yabani salatalık) ile beslenme sonrasında erken dönemde görülen şiddetli kaşeksi olgusunu sunmak istedik. 15 yaşında erkek hasta hastanemiz yo¤un bakım ünitesine bulantı-kusma, kas güçsüzlü¤ü, metabolik asidoz, solunum yetmezli¤i ve bilinç bulanıklığı ile kabul edildi. Hikayesinde bilinen bir özellik yoktu. Semptomları belirmeden kısa bir süre önce caigua ile beslenmişti. Hastada 1 ay içinde geliş kilosunun %20’sinden fazlasını hızla kaybettirecek şiddetli kaşeksi gözlemlendi. "Akut dissemine ensefalomyelit (ADEM) sendromu" ayırıcı tanıda düşünüldü ancak manyetik rezonans incelemesinde (MRI) bir bulguya rastlanmadı. Caigua özellikle kilo vermek için dünyada yaygın kullanılmakta olup, hızlı başlangıçlı açıklanamayan kaşeksi olgularında caigua zehirlenmesi akılda tutulmalıdır.

Caigua besin zehirlenmesini takiben gelişen şiddetli kaşeksi ve uzamış yoğun bakım süresi

We aimed to present a case with severe cachexia in the early period after ingestion of caigua (cyclanthera pedata) which is a slender tropical vine indigenous to South America. A 15-year-old male patient was referred to our intensive care unit with acute nausea and vomiting, muscle weakness, metabolic acidosis, respiratory failure, and loss of consciousness. His past medical history was unremarkable. He had eaten caigua shortly before onset of symptoms. He had rapidly progressive cachexia and lost more than 20 percent of his weight over 1 month. "Acute disseminated encephalomyelitis (ADEM) syndrome" had been considered as one possible differential diagnosis, but there was no diagnostic feature shown on the magnetic resonance imaging (MRI). Caigua is being used especially to lose weight widely around the world and caigua poisoning should be kept in mind in patients having rapid onset of unexplained cachexia.

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