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Prayong Vachvanichsanong a Louis Lebel b
Abstract
Background: Djenkolism is djenkol bean poisoning, characterized by acute renal failure, urinary obstruction and spasmodic pain. The effects of djenkol bean consumption on the urinary tract without overt symptoms and long-term outcome are not established. This paper examines the association between djenkol bean ingestion and urine abnormalities in school children. Method: 609 school children aged 7-11 years in five urban Hat-Yai schools were interviewed, and had their urine analyzed. All children included in the study had normal blood pressure for age, no illness (including respiratory tract symptoms) and were not taking medication. Results: 78% of the children had a history of eating djenkol bean and of these 31% had done so in the past 24 h. Children with hematuria were almost four times (crude odds ratio = 3.7) as likely to have a history of eating djenkol beans as those with normal urine. Crystaluria and pyuria were not significantly more common among those eating the beans. The risk of having hematuria did not change with increasing consumption, or time since last eaten, or type of preparation even after adjustment for sex and age. Conclusion: Djenkol bean consumption may be defined as one of the probable causes of hematuria in the area where the djenkol tree grows.
Key Words Djenkol bean Hematuria
Introduction
The djenkol bean (Archidendron jiringa or A. lobatum, formerly Pithecellobium) is a well-known bean eaten in the southern part of Thailand and some other countries in Southeast Asia. The local names of the djenkol tree are danyin-thee (Burma), jering, jenkol, genkol, djenkol (Indonesia), krakos (Cambodia) yiniking, yi-ring, jering (Malaysia), ma-niang, cha-niang, niang, kra-niang and niang-yai (Thailand) [1]. The djenkol tree grows up to 25 m in height, with a large rounded crown. Djenkol pods are dark purple and there is a constriction between the large beans. Each pod contains 3-9 beans. The bean is orbicular flat shining yellow when young and brown when old, and with the skin removed reveals the pale-yellow content with a sulfurous odor (fig. 1).
The djenkol bean contains djenkolic acid, which has been proposed to form sharp needle-shaped crystals in the urine and may lacerate renal tissue and cause bleeding or obstruction [1-4]. Infrequent reports have suggested that...