Medium Cut-Off Membrane Can Be a New Treatment Tool in Amanita phalloides Poisoning

Wilderness Environ Med. 2021 Jun;32(2):192-197. doi: 10.1016/j.wem.2020.12.002. Epub 2021 Mar 4.

Abstract

Mushroom poisoning is a common health problem that can be seen seasonally and geographically. Most mushroom poisoning requiring treatment worldwide is due to Amanita phalloides. Although liver failure and kidney injury are frequent, poisoning can also lead to more serious clinical situations, such as shock, pancreatitis, encephalopathic coma, cardiac failure, disseminated intravascular coagulation, and multiple organ dysfunction syndrome, and may cause death. In addition, when standard treatment approaches fail, extracorporeal treatment methods are often used. We report 2 cases in which hemodialysis with medium cut-off membrane was performed. We observed an improvement in liver and kidney function in both of our cases. The first case recovered, but the second case proved fatal owing to Acinetobacter sepsis, despite an improvement in renal function. Medium cut-off membrane hemodialysis may be an alternative option in the treatment of Amanita phalloides poisoning.

Keywords: acute kidney injury; dialyser; extracorporeal treatment; hemodialysis; intoxication; mushroom poisoning.

Publication types

  • Case Reports

MeSH terms

  • Amanita
  • Humans
  • Liver Failure, Acute*
  • Liver Transplantation*
  • Mushroom Poisoning* / diagnosis
  • Mushroom Poisoning* / therapy

Supplementary concepts

  • Amanita phalloides