title: Management of maternal Amanita phalloïdes poisoning during the first trimester of pregnancy: a case report and review of the literature.
abstract: BACKGROUND
  Amanita phalloïdes poisoning produces acute liver failure and often death. Maternal poisonings are rare, and medical decisions of abortion or liver transplantation in this critical situation frequently are based on laboratory data. We report here the case of a 22-year-old-woman in the 11th week of pregnancy, who ingested mushrooms.
  
  
  METHODS
  The patient's clinical symptoms (e.g., vomiting and diarrhea) and blood chemistry data (persistent increases of aspartate aminotransferase and alanine aminotransferase and severe decreases in prothrombin, factor V, factor II, factor VII, and factor X) indicated poisoning of medium severity. The management consisted of intravenous hydration, and administration of silymarine and N-acetylcysteine. No fetal damage was observed, and birth and development of the infant (now 2 years of age) proceeded without incident.
  
  
  CONCLUSIONS
  Abortion is not necessarily indicated in maternal poisoning by A. phalloïdes, even in the first trimester of pregnancy.
authors.affiliation: Centre Hospitalier Universitaire de Nîmes, Service de Biochimie and Département de l'Urgence, Urgences Medico-Chirurgicale d'Hospitalisation, 5 Rue Hoche, 30006 Nîmes, France. jean-christophe.boyer@chu-nimes.fr
authors.forename: J C
authors.initials: JC
authors.lastname: Boyer
authors.forename: F
authors.initials: F
authors.lastname: Hernandez
authors.forename: J
authors.initials: J
authors.lastname: Estorc
authors.forename: J E
authors.initials: JE
authors.lastname: De La Coussaye
authors.forename: J P
authors.initials: JP
authors.lastname: Bali
mesh_terms: D000328:Adult; D000545:Amanita; D005260:Female; D006801:Humans; D009145:Mushroom Poisoning / Q000382:microbiology / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000382:microbiology / Q000628:therapy*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First