Which Patients Are at Greatest Risk From Mushroom Poisoning?
Kristine Novak
Almost 20% of patients with liver damage from mushroom (Amanita) poisoning and peak levels of total bilirubin greater than 2 mg/dL require liver transplantation or die, researchers report in the May issue of Clinical Gastroenterology and Hepatology.
The authors show that peak level of aspartate aminotransferase (AST) below 4000 IU/L identifies patients who can be safely monitored in a local hospital, whereas patients with levels of bilirubin >2 mg/dL or AST >4000 IU/L should be transferred to a liver transplant center. Women and older patients were more likely to have a poor outcome than men and younger patients.
Acute liver failure after toxic mushroom ingestion is a significant problem worldwide and in the United States. The genus Amanita accounts for more than 90% of fatal mushroom poisonings. Although exposures to toxic mushrooms often cause no or only mild symptoms, some patients develop severe hepatic necrosis and fulminant hepatic failure.
There has been no reliable system to differentiate between patients who can be safely treated at a local hospital vs those that require transfer to a transplant center.
Almost 20% of patients with liver damage from mushroom (Amanita) poisoning and peak levels of total bilirubin greater than 2 mg/dL require liver transplantation or die, researchers report in the May issue of Clinical Gastroenterology and Hepatology.
The authors show that peak level of aspartate aminotransferase (AST) below 4000 IU/L identifies patients who can be safely monitored in a local hospital, whereas patients with levels of bilirubin >2 mg/dL or AST >4000 IU/L should be transferred to a liver transplant center. Women and older patients were more likely to have a poor outcome than men and younger patients.
Acute liver failure after toxic mushroom ingestion is a significant problem worldwide and in the United States. The genus Amanita accounts for more than 90% of fatal mushroom poisonings. Although exposures to toxic mushrooms often cause no or only mild symptoms, some patients develop severe hepatic necrosis and fulminant hepatic failure.
There has been no reliable system to differentiate between patients who can be safely treated at a local hospital vs those that require transfer to a transplant center.
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