Monitoring of haemostatic parameters in five cases of Amanita phalloides poisoning.
The effects of Amanita phalloides poisoning on haemostatic parameters were determined in five members of two families with particular attention to coagulation inhibitors. According to the prothrombin time and factor V level, one patient had severe poisoning, one moderate and the other three had only mild toxicity. The decrease of inhibitors (antithrombin III, proteins C and protein S) was not followed by coagulation activation as assessed by the moderate increase in D-dimers and the absence of a clinically significant coagulopathy. Anti-thrombin III showed little decrease, except in the more severely affected case and protein C paralleled the decrease in factor VII, but to a lesser extent. The decrease in coagulation factors and inhibitors could not be explained by their half-lives alone. Factor V was a better indicator of the recovery of liver synthesis function than other factors. Our observations indicate that monitoring coagulation inhibitors in Amanita poisoning is not more informative than prothrombin time and coagulation factor V, both usually recognized as early prognostic markers of fulminant hepatic failure.
Christen
Y
Y
Haemostasis Unit, University Cantonal Hospital, Geneva, Switzerland.
Minazio
P
P
de Moerloose
P
P
D000293:Adolescent; D000545:Amanita; D000990:Antithrombin III / Q000378:metabolism*; D002648:Child; D005165:Factor V / Q000378:metabolism*; D005260:Female; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009145:Mushroom Poisoning / Q000097:blood*; D011379:Prognosis; D011486:Protein C / Q000378:metabolism*; D017293:Protein S / Q000378:metabolism*; D011517:Prothrombin Time
D011486:Protein C; D017293:Protein S; D000990:Antithrombin III; D005165:Factor V