Intoxication of the immature fruit of the ackee (Blighia sapida Koenig): Summary and development

Deaths linked to the consumption of plants are sometimes overlooked by health personnel in tropical environments. Parts of several plants are recognized as potentially toxic, including the fruit of the ackee. This review paper aimed to synthesize data on the toxicity of the fruit of the ackee (Blighia sapida) and a brief overview on the measures of management of its acute intoxication. This was a documentary and analytical study. We made an analysis/synthesis of the articles relating to the poisoning with the immature fruit of the ackee. The PubMed, AJOL and Google scholar databases were used. The ackee is a plant native to West-Africa. Known by several names, lissètin in Fon in Benin, atsia in Evé in Togo, Finzan in Bambara in Mali, its aril contains lipids, proteins, carbohydrates, vitamins and trace elements. Hypoglycin is present in two forms A (2-methylene-cyclopropane-alanine) and B found in immature fruit, a very toxic compound which disrupts β-oxidation of fatty acids. Acute immature fruit poisoning, manifests as an acute hypoglycemic encephalopathy, gastrointestinal signs, hydro-electrolyte disturbances, metabolic acidosis and liver damage. The detection of urinary dicarboxylic acids is pathognomonic. Its treatment is symptomatic. A crude gastrointestinal and hepatic symptomatology characterizes chronic intoxication. The ackee is a tree whose unripe fruit is of acute lethal toxicity. Treatment of acute intoxication is symptomatic.