Intensive hemodialysis and hemoperfusion treatment of Amanita mushroom poisoning
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Over a period of fifteen years, 41 patients including 23 males and 18 females with Amanita mushroom poisoning were treated at the University Hospital of Lund, Sweden. The intensity of poisoning was graded according to serum transaminase elevations and prothrombin time reductions. Severity was mild in 16 patients (Group A), moderate in 14 (Group B) and severe in 11 (Group C). Members of Group C reported shorter latency periods before the onset of symptoms, (10±1 hours,p<0.05) and longer delays in treatment, (34±4 hours), than did the other patients. Intensive treatment was begun before the results of urine amatoxin assays were reported. Treatment consisted of: fluid and electrolyte replacement, oral activated charcoal and lactulose, IV penicillin, combined hemodialysis and hemoperfusion in two 8 hour sessions, some received IV thioctic acid, others IV silibinin, all received a special diet. This combination of treatment modalities was used to accelerate the elimination of amatoxin from the patients' bodies. The longest period of hospitalization, 13±2 days, was required by the patients of Group C (p<0.01). All patients improved and were discharged from the hospital asymptomatic. No sequelae were later reported for the majority of those moderately and severely poisoned. We have concluded that intensive combined treatment applied in these cases is effective in relieving patients with both moderate and severe amanitin poisoning.
- Editorial. Mushroom poisoning. Lancet 1980(ii): 351–352.
- Faulstich H, Talas A, Wellhöner HH. Toxicokinetics of labelled amatoxins in the dog. Arch Toxicol 1985; 56: 190–194.
- Faulstich H. New aspects of Amanita poisoning. Klin Wochenschr 1979; 57: 1143–1152.
- McClain JL, Hause DW, Clark MA. Amanita phalloides mushroom poisoning: A cluster of four fatalities. Journal of Forensic Sciences 1989; 34: 83–87.
- Olson KR, Pond SM, Seward J, Healey K, Woo OF, Becker CE. Amanita phalloides-type mushroom poisoning. West J Med 1982; 137: 282–289.
- Hanrahan JP, Gordon MA. Mushroom poisoning: Case reports and a review of therapy. JAMA 1984; 251: 1057–1061.
- Ponikvar R, Drinovec J, Kandus A, Varl J, Gucek A, Malovrh M. Plasma exchange in management of severe acute poisoning with Amanita phalloides. Progress in clinical and biological research 1990; 337: 327–329.
- Mercuriali F, Sirchia G. Plasma exchange for mushroom poisoning. Transfusion 1977; 17: 644–646.
- Faulstich H, Zobeley S, Trischmann H. A rapid radioimmunoassay, using a nylon support, for amatoxins from Amanita mushrooms. Toxicon 1982; 20: 913–924.
- Mitchel DH. Amanita mushroom poisoning. Ann Rev Med 1980; 31: 51–57.
- Jaeger A, Jehl F, Flesh F, Sauder P, Kopferschmitt J. Kinetics of amatoxins in human poisoning: therapeutic implications. Clin Toxicol 1993; 31: 63–80.
- Floersheim GL. Treatment of human amatoxin mushroom poisoning: Myths and advances in therapy. Medical Toxicology 1987; 2: 1–9.
- Klein AS, Hart J, Brems JJ, Goldstein L, Klaus L, Busuttil RW. Amanita poisoning: Treatment and the role of liver transplantation. Am J Med 1989; 86: 187–193.
- Pond SM, Olson KR, Woo OF, Osterloh JD, Ward RE, Kaufman DA, Moody RR. Amatoxin poisoning in Northern California, 1982–1983. West J Med 1986; 145: 204–209.
- Fantozzi R, Ledda F, Caramelli L, Moroni F, Blandina P, Masini E, Botti P, Peruzzi S, Zorn M, Mannaioni PF. Clinical findings and follow-up evaluation of an outbreak of mushroom poisoning — survey of Amanita phalloides poisoning. Klin Wochenschr 1986; 64: 38–43.
- Becker CE, Tong TG, Boerner U, Roe RL, Scott RAT, Mac-Quarrie MB, Bartter F. Diagnosis and treatment of Amanita phalloides-type mushroom poisoning. West J Med 1976; 125: 100–109.
- Wauters JP, Rossel C, Farquet JJ. Amanita phalloides poisoning treated by early charcoal haemoperfusion. Br Med J 1978; II: 1465.
- Piering WF, Bratanow N. Role of the clinical laboratory in guiding treatment of Amanita virosa mushroom poisoning: Report of two cases. Clin Chem 1990; 36: 571–574.
- Floersheim GL, Eberhard M, Tschumi P, Duckert F. Effects of Penicillin and Silymarin on liver enzymes and blood clotting factors in dogs given a boiled preparation of Amanita phalloides. Toxicology and Applied Pharmacology 1978; 46: 455–462.
- Piqueras J. Hepatotoxic mushroom poisoning: diagnosis and management. Mycopathologia 1989; 105: 99–110.
- Winchester JF, Rotellar C. Hemoperfusion. In: The Principles and Practice of Nephrology. Jacobson HR, Striker GE, Klahr S, ed., Philadelphia. Hamilton: B.C. Dekker 1991: 808.
- Woodle ES, Moody RR, Cox KL, Cannon RA, Ward RE. Orthotopic liver transplantation in a patient with Amanita poisoning. JAMA 1985; 253: 69–70.
- Myler RK, Lee JC, Hopper J. Renal tubular necrosis caused by mushroom poisoning. Arch Intern Med 1964; 114: 196–204.
- Intensive hemodialysis and hemoperfusion treatment of Amanita mushroom poisoning
Volume 131, Issue 2 , pp 107-114
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- Amanita mushrooms
- Industry Sectors