Jengkol or kejengkolan poisoning is cause of acute kidney pains (acute renal failure), but the deaths caused by poisoning is never the case.
Determination jengkol poisoning diagnosis for a doctor who had seen cases of poisoning jengkol and never smelled a typical jengkol is not difficult. Anamnesa is rigorous to reveal that the signs of poisoning occur some time after eating the fruit jengkol. Treatment is not difficult. In the hospital tried to diuresis can be resumed through the provision of intravenous fluids are made slightly alkaline with sodium bicarbonate.
Is it jengkol acid? Jengkol acid or djenkolzuur (Netherlands), djenkolic acid (Great Britain) or Djenkolsaure (France) is a kind of amino acid berunsur sulfur contained in the fruit jengkol in free form; not as an element in the protein or other bound form. Amino acids in nature is indeed a protein constituent elements. But it may even be present in natural amino acids that are not part of the protein, ie amino acids of non-protein, such as citrulline, ornithine, etc..
Today has been agreed on by researchers that jengkol poisoning caused by acid precipitation of crystals jengkol inside the ducts urogenital tract, causing mechanical obstruction. Jengkol acid crystals in the type of sharp needles in the urine sediment was pathognomonis for this type of poisoning but the crystals may not always be found.
Jengkol acid has a melting point (Melting Point) as high as 300 ° C - 330 ° C (decomp). Forming colorless crystals, a needle-shaped or spindle (spindle). Jengkol acid is odorless. Jengkol peculiar odor not caused by acid jengkol, but by the description jengkol acid.
If somebody ate the fruit jengkol, then the acid will come jengkol ingested. Therefore, in the shape of the fruit was free amino acids, it is not necessary for the absorption suffered hydrolysis, such as amino acids which are elements of the protein. It can be seen from the fact that in a short amount of time, sometimes less than hours after eating the fruit jengkol, amino acids have been present in urine fruit-eating. To better understand the precipitation of crystals in acidic jengkol gindjal need to know first some chemical properties acid jengkol.
As amino acids, acids are amphoteric jengkol, which is soluble in acid or alkaline. However, by having a chemical structure similar to cystine, which is also an amino acid berunsur sulfur, as well as the acid cystine jengkol not or not very soluble in water with a pH of biological period.
The query arises: If it is difficult jengkol acid soluble in water with a pH of biological (7.4), how jengkol acid can be transported by the blood from the intestines to the kidneys to be excreted? From research by ultrafiltration and dialysis equilibrium (equilibration dialysis) obtained proof that jengkol acid in the blood present in soluble form, which is bound to serum albumin.
What happens in the kidney? In the kidney jengkol acid molecules can pass through a semipermeable membrane of the glomerulus. Albumin alone can not pass through this membrane by having large a molecule. So complex and serum albumin jengkol acid dissociates to produce serum albumin and jengkol acid-free and acid-free jengkol these past and present in the glomerular membrane glomerular ultrafiltrat. There still remains the likelihood that in addition to glomerular filtration occurs through jengkol acid secretion is also actively through the kidney tubuli, but this still needs further verification.
The discovery of a variety of substances that ought to not dissolve in water but can be transported in a soluble state by the blood is not new. It's been known since long, that substances that are soluble only in fats or overweight solvents, such as carotene, bilirubin, steroids and various types of medications react with proteins in the blood to form soluble complexes in the blood, thus allowing its transportation. Such bonding is not a chemical bond, but a physical bond is basically broken down again depending on the atmosphere.
With this can be understood now why the treatment of poisoning jengkol performed by administering intravenous fluids with the purpose of reviving the diuresis. The addition of sodium bicarbonate will facilitate the dissolution of the crystals back to jengkol acid excreted with urine.
Jengkol acid which is now contained in ultrafiltrat basically crystallize in to crystals because there is no longer which makes it more soluble proteins such as occurs in the blood. on the next trip going back a variety of water absorption by the decline of the curve of Henle. All of this causes acid jengkol reached saturation point (oversaturated) and mengendaplah jengkol acid crystals form as needles are sharp.
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