JENGKOLIC POISONING

DIVISION OF PEDIATRIC EMERGENCY/INTENSIVE CARE

DEPARTMENT OF CHILD HEALTHMEDICAL FACULTY

UNIVERSITY OF SUMATRA UTARA

Dr.MUNAR LUBIS,SpA(K)

JENGKOL (PHITECOLOBIUM LOBATUM) : Food content as pete have composition B1 In the some region of Indonesia, jengkol is common as the food Serving : emping & rendang jengkol. Oudor specific Jengkolic poisoning : after eating jengkol cooked /

jengkolCause: jengkol is composed of jengkol acid , amino acid that have sulphur

Chemistry structure of jengkol acid:

S – CH2 – CHNH2 – COOH

CH2

S – CH2 – CHNH2 – COOH In jengkol : formaldehyde + cysteine.Jengkol acid is not dissoluble in cool water ( in

30 °C content 1 : 2.000 ), in the hot water 1 : 200

INCIDENCE boy : girls = 9 : 1, 4-7 years old, 1,5 years old ( young in age )

Cause : idiopathy, depend on individual susceptibility jengkol acid insufficiency renal Moenajat Wiratmadja, et al : is not all people eating jengkol can be jengkolic poisoning Van Veen dan Hyman : Jengkolic poisoning depend on individual susceptibility

CLINICAL FEATURES :Cause of hablur (crystal) jengkol acid obstruct bladder. Symptoms show up 5 - 12 ours after eating jengkol.

Sooner 2 ours and delay 36 ours.

SYMPTOMS OF JENGKOLIC POISONING : Back pain (colic), sometimes there is sezure Oliguria to anuria, Colour of urine is red Meteorismus and difficulty defecation / (-) Oudor of breathing and urine is jengkol

In the severe jengkolic poisoning : Pain in the renal area (colic) Dysuria Meteorismus, nausea, vomiting, flatus and defecation (-) Anuria

In Children : urine infiltrat on penis, scrotum

Supra pubic and inguinal Microscopy: urine hablur jengkol acid

roxet Djaeni (1967) : hablur alkali acid

DIAGNOSIS :Simply

TREATMENT :Mild : vomiting, abdominal pain / back pain outpatient drinking much

giving NaHCO3 (4 tablet)

Severe : oliguri, hematuri, anuri, can not drinking inpatient IVFD D 5% + Bicnat, dose 2 - 5 mEq, in 4 - 8 ours Antibiotica secondary infection Diuretic

PROGNOSIS :Generally Good, It will getting worst acute insufficiency renal

PREVENTION :Avoid jengkol !!

Some Advice : Before jengkol is cooked, soak in warm water in one night. Keep the water still warm. Bury jengkol for 2-3 days before, it can removal jengkol acid Wallahu a’lam…..