Djenkolism: case report and literature review

Figures & data

Figure 1 Djenkol bean.

Note: Photo courtesy of MR Nirmala.

Figure 2 Mild hydronephrosis of left kidney on ultrasound.

Table 1 Demographic and clinical characteristics of reported cases of djenkolism

Article (year)	Country	Number of patients	Age range (years)	Sex	Number of beans	Onset (days)	Abdominal/loin, colicky pain	Dysuria	Hypertension	Macroscopic hematuria	Oliguria/anuria
Areekul et al^Citation17 (1978)	Thailand	1	8	M, 1	10	NR	NR	NR	NR	NR	Anuria
Eiam-Ong et al^Citation9 (1987)	Thailand	22	15–57	M, 15; F, 7	3–20	Hours	21/22	17/22	8/22	15/22	Anuria, 10
H’ng et al^Citation10 (1991)	Malaysia	2	21, 25	M, 2	20, 10	2, 3	Bilateral loin pain with CVA tenderness	2/2	2/2	2/2	Anuria, 1; oliguria, 1
Reimann and Sukaton^Citation3 (1956)	Indonesia	16	Adult	NR	10–20	2–12 hours	16/16	16/16	3/16	10/16	Oliguria, 10; anuria, 4
Segasothy et al^Citation11 (1995)	Malaysia	1	26	M	3	4	Bilateral loin pain with CVA tenderness	1	1/1	1/1	Oliguria
Suharjono and Sadatun^Citation6 (1968)	Indonesia	50	1.5–12	M, 45; F, 5	1–10	2–36 hours	21/50 back pain/colic	24/50	NR	21/50	Oliguria, 7; anuria, 8
West et al^Citation12 (1973)	Indonesia	2	7; NR	M, 1; NR, 1	NR	NR	NR	NR	NR	NR	NR
Wong et al^Citation13 (2007)	Malaysia	1	45	M	NR	1	Left loin pain	NR	NR	1/1	Oliguria, anuria by day 3
Yong et al^Citation14 (1995)	Malaysia	1	35	M	NR	Hours	Severe abdominal pain	NR	1/1	1/1	NR

Abbreviations: M, male; F, female; NR, not reported; CVA, costovertebral angle.

Table 2 Laboratory and imaging characteristics, treatment, and outcome of reported cases of djenkolism

Article (year)	Number of patients	BUN (mg/dL)	Creatinine (mg/dL)	Urine analysis	Imaging/diagnostics	Treatment	Outcome
Areekul et al^Citation17 (1978)	1	NR	NR	NR	X-ray, no stones	Surgery for stone removal	Recovered (4 days)
Eiam-Ong et al^Citation9 (1987)	22	7–100	0.9–10	Proteinuria, 10; leukocyturia, 2; crystals, 1	NR	Hydration-all; diuretic, 8; alkalinization, 8; dialysis, 1	All recovered (2–14 days)
H’ng et al^Citation10 (1991)	2	61; 114	7.8; 14.1	Turbid urine	X-ray, no stones; US: increased echogenicity; prominent pyramis; no hydronephrosis	Hydration, alkalinization	All recovered (5 days;
Reimann and Sukaton^Citation3 (1956)	16	20–70	NR	Milky urine at beginning (NQ); crystal, 6	NR	Hydration, alkalinization, morphine	All recovered (3 days)
Segasothy et al^Citation11 (1995)	1	45	5.2	Turbid urine	US: not increased echogenicity, pyramid hyperechoic, enlarged; no hydronephrosis	Hydration, alkalinization	Recovered
Suharjono and Sadatun^Citation6 (1968)	50	20–340	NR	Turbid urine, 9; crystals, 30; microscopic hematuria, 36	NR	NR	Recovered, 47; died, 3
West et al^Citation12 (1973)	2	NR	NR	Crystals, 2	NR	Irrigation of the urethra, bladder	Recovered, 1; died, 1
Wong et al^Citation13 (2007)	1	18	1.99	Foul-smelling urine	US: normal kidney with minimal right hydronephrosis	Bilateral ureteric stenting after failed conservative treatment (Cr increased to 9.59); thick “tomato sauce” sludge found	Recovered (stent removed 4 days later)
Yong et al^Citation14 (1995)	1	11	3, 6	Turbid urine	X-ray, no stones	Hydration	Recovered (3 days; blue urine secondary to jamu ingestion)

Abbreviations: BUN, blood urea nitrogen; NR, not reported; Cr, creatinine; NQ, not quantified; US, ultrasound.

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