title: Treatment of Amanita phalloides poisoning: I. Retrospective evaluation of plasmapheresis in 21 patients.
abstract: Amanita phalloides poisoning is the most common cause of lethal mushroom poisoning (lethality >20% in adults). A specific antidote against the amanitin toxins is not available. This retrospective study reports results in 21 patients (12 males, 9 females; ages 9-59 years) treated for amanita phalloides poisoning between 1984 and 1993. Plasmapheresis was carried out using a commercial plasma protein solution (Biseko, Biotest, Dreieich, Germany) in 17 patients, fresh plasma in 2 patients, and human albumin/Ringer's solution in 2 patients. Ancillary drugs, including penicillin and silibinin, also were used for detoxification, correction of blood-clotting deficiencies, and hepatic protection. One patient died of acute hepatic failure. The results, assessed using mortality (4.8% overall) and frequency of complications, indicate that plasmapheresis is a safe and effective treatment for amanita phalloides poisoning but that further investigations are needed, especially involving measurements of efficacy and the efficiency of toxin removal.
authors.affiliation: Medizinische Klinik, Klinikum Ernst von Bergmann Potsdam, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Jander
authors.forename: J
authors.initials: J
authors.lastname: Bischoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000545:Amanita; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000150:complications / Q000628:therapy*; D010956:Plasmapheresis; D012189:Retrospective Studies