title: The futility of hemoperfusion and hemodialysis in Amanita phalloides poisoning.
abstract: Amanita phalloides mushrooms are extremely toxic. A variety of treatments have been proposed based as often on anecdotal experience as on firm evidence. General consensus exists regarding some treatments, such as the use of silibinin, penicillin, and activated charcoal. The most polarized debate concerns the value of extracorporeal elimination. We describe a case of 2 adults with confirmed Amanita phalloides poisoning treated with hemodialysis (HD) immediately after arrival at our tertiary care hospital (23 h after ingestion) and later with hemoperfusion (HP); a series blood samples were taken to determine the clearance of the toxin by each method. No amatoxin was detected before treatment, after treatment, or in the HD/HP circuits. Neither HD nor HP contributed to the clearance of amatoxin.
authors.affiliation: Oregon Poison Center, Portland, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Mullins
authors.forename: B Z
authors.initials: BZ
authors.lastname: Horowitz
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000545:Amanita; D000546:Amanitins / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D009145:Mushroom Poisoning / Q000097:blood / Q000628:therapy*; D006435:Renal Dialysis; D016896:Treatment Outcome
chemical_list: D000546:Amanitins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase