Acute Liver Failure Caused by Amanita phalloides Poisoning
Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mush...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2012/487480 |
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| author | Luca Santi Caterina Maggioli Marianna Mastroroberto Manuel Tufoni Lucia Napoli Paolo Caraceni |
| author_facet | Luca Santi Caterina Maggioli Marianna Mastroroberto Manuel Tufoni Lucia Napoli Paolo Caraceni |
| author_sort | Luca Santi |
| collection | DOAJ |
| description | Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options. |
| format | Article |
| id | doaj-art-dc7b2067ae6d49959303209cf0e2c992 |
| institution | Kabale University |
| issn | 2090-3448 2090-3456 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hepatology |
| spelling | doaj-art-dc7b2067ae6d49959303209cf0e2c9922025-02-03T01:28:00ZengWileyInternational Journal of Hepatology2090-34482090-34562012-01-01201210.1155/2012/487480487480Acute Liver Failure Caused by Amanita phalloides PoisoningLuca Santi0Caterina Maggioli1Marianna Mastroroberto2Manuel Tufoni3Lucia Napoli4Paolo Caraceni5U.O. Semeiotica Medica, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyU.O. Semeiotica Medica, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyS.S.D. Liver Transplant, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyU.O. Semeiotica Medica, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyU.O. Semeiotica Medica, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyU.O. Semeiotica Medica, Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, ItalyMushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options.http://dx.doi.org/10.1155/2012/487480 |
| spellingShingle | Luca Santi Caterina Maggioli Marianna Mastroroberto Manuel Tufoni Lucia Napoli Paolo Caraceni Acute Liver Failure Caused by Amanita phalloides Poisoning International Journal of Hepatology |
| title | Acute Liver Failure Caused by Amanita phalloides Poisoning |
| title_full | Acute Liver Failure Caused by Amanita phalloides Poisoning |
| title_fullStr | Acute Liver Failure Caused by Amanita phalloides Poisoning |
| title_full_unstemmed | Acute Liver Failure Caused by Amanita phalloides Poisoning |
| title_short | Acute Liver Failure Caused by Amanita phalloides Poisoning |
| title_sort | acute liver failure caused by amanita phalloides poisoning |
| url | http://dx.doi.org/10.1155/2012/487480 |
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