Guarigione dopo intossicazione grave da funghi selvatici (encefalopatia di IV grado) con sola terapia medica intensiva e senza trapianto di fegato. Caso clinico.

Translated title of the contribution: Recovery after serious mushroom poisoning (grade IV encephalopathy) with intensive care support and without liver transplantation. Clinical case

G. Ronzoni, S. Vesconi, D. Radrizzani, C. Corbetta, M. Langer, G. Iapichino

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and particularly of its complications, remains a challenge in emergency medicine. Klein and coworkers reviewed the role of liver transplantation in amatoxin poisoning as a useful therapeutic tool for patients with severe impairment of liver function. Their indication for intervention is the presence of any of the following signs: grade 2 encephalopathy or higher; prothrombin time twice than normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past autumn two patients with fulminant hepatic failure due to amatoxin poisoning were referred to our institutions as candidates for liver transplantation, since both satisfied Klein's criteria. However, due to shortage of organ donors it was impossible to transplant them over the following days. Despite they did not receive liver transplantation, both patients wakened from coma, their liver function improved, and they recovered from terminal amatoxin poisoning. After one year, both patients are long-term survivors, in good health and without any sequelae either in brain or liver function.

Original languageItalian
Pages (from-to)383-387
Number of pages5
JournalMinerva Anestesiologica
Volume57
Issue number6
Publication statusPublished - Jun 1991

Fingerprint

Mushroom Poisoning
Brain Diseases
Critical Care
Liver Transplantation
Poisoning
Liver
Hyperbilirubinemia
Acute Liver Failure
Emergency Medicine
Agaricales
Prothrombin Time
Liver Failure
Coma
Hypoglycemia
Survivors
Therapeutics
amatoxin
Tissue Donors
Transplants
Glucose

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Guarigione dopo intossicazione grave da funghi selvatici (encefalopatia di IV grado) con sola terapia medica intensiva e senza trapianto di fegato. Caso clinico. / Ronzoni, G.; Vesconi, S.; Radrizzani, D.; Corbetta, C.; Langer, M.; Iapichino, G.

In: Minerva Anestesiologica, Vol. 57, No. 6, 06.1991, p. 383-387.

Research output: Contribution to journalArticle

Ronzoni, G. ; Vesconi, S. ; Radrizzani, D. ; Corbetta, C. ; Langer, M. ; Iapichino, G. / Guarigione dopo intossicazione grave da funghi selvatici (encefalopatia di IV grado) con sola terapia medica intensiva e senza trapianto di fegato. Caso clinico. In: Minerva Anestesiologica. 1991 ; Vol. 57, No. 6. pp. 383-387.
@article{494f7987996e4e7d805b87c0e32872b1,
title = "Guarigione dopo intossicazione grave da funghi selvatici (encefalopatia di IV grado) con sola terapia medica intensiva e senza trapianto di fegato. Caso clinico.",
abstract = "Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15{\%}, which approaches 100{\%} when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and particularly of its complications, remains a challenge in emergency medicine. Klein and coworkers reviewed the role of liver transplantation in amatoxin poisoning as a useful therapeutic tool for patients with severe impairment of liver function. Their indication for intervention is the presence of any of the following signs: grade 2 encephalopathy or higher; prothrombin time twice than normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past autumn two patients with fulminant hepatic failure due to amatoxin poisoning were referred to our institutions as candidates for liver transplantation, since both satisfied Klein's criteria. However, due to shortage of organ donors it was impossible to transplant them over the following days. Despite they did not receive liver transplantation, both patients wakened from coma, their liver function improved, and they recovered from terminal amatoxin poisoning. After one year, both patients are long-term survivors, in good health and without any sequelae either in brain or liver function.",
author = "G. Ronzoni and S. Vesconi and D. Radrizzani and C. Corbetta and M. Langer and G. Iapichino",
year = "1991",
month = "6",
language = "Italian",
volume = "57",
pages = "383--387",
journal = "Minerva Anestesiologica",
issn = "0375-9393",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "6",

}

TY - JOUR

T1 - Guarigione dopo intossicazione grave da funghi selvatici (encefalopatia di IV grado) con sola terapia medica intensiva e senza trapianto di fegato. Caso clinico.

AU - Ronzoni, G.

AU - Vesconi, S.

AU - Radrizzani, D.

AU - Corbetta, C.

AU - Langer, M.

AU - Iapichino, G.

PY - 1991/6

Y1 - 1991/6

N2 - Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and particularly of its complications, remains a challenge in emergency medicine. Klein and coworkers reviewed the role of liver transplantation in amatoxin poisoning as a useful therapeutic tool for patients with severe impairment of liver function. Their indication for intervention is the presence of any of the following signs: grade 2 encephalopathy or higher; prothrombin time twice than normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past autumn two patients with fulminant hepatic failure due to amatoxin poisoning were referred to our institutions as candidates for liver transplantation, since both satisfied Klein's criteria. However, due to shortage of organ donors it was impossible to transplant them over the following days. Despite they did not receive liver transplantation, both patients wakened from coma, their liver function improved, and they recovered from terminal amatoxin poisoning. After one year, both patients are long-term survivors, in good health and without any sequelae either in brain or liver function.

AB - Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and particularly of its complications, remains a challenge in emergency medicine. Klein and coworkers reviewed the role of liver transplantation in amatoxin poisoning as a useful therapeutic tool for patients with severe impairment of liver function. Their indication for intervention is the presence of any of the following signs: grade 2 encephalopathy or higher; prothrombin time twice than normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past autumn two patients with fulminant hepatic failure due to amatoxin poisoning were referred to our institutions as candidates for liver transplantation, since both satisfied Klein's criteria. However, due to shortage of organ donors it was impossible to transplant them over the following days. Despite they did not receive liver transplantation, both patients wakened from coma, their liver function improved, and they recovered from terminal amatoxin poisoning. After one year, both patients are long-term survivors, in good health and without any sequelae either in brain or liver function.

UR - http://www.scopus.com/inward/record.url?scp=0026167563&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026167563&partnerID=8YFLogxK

M3 - Articolo

VL - 57

SP - 383

EP - 387

JO - Minerva Anestesiologica

JF - Minerva Anestesiologica

SN - 0375-9393

IS - 6

ER -