title: Amanita bisporigera ingestion: mistaken identity, dose-related toxicity, and improvement despite severe hepatotoxicity.
abstract: Ingestion of wild mushrooms has led to unintentional poisonings caused by mistaken identity. We report 3 cases of exposure to Amanita bisporigera, demonstrating dose-related toxicity. The use of nasobiliary drainage as a novel approach to interrupting the enterohepatic circulation of amatoxins is illustrated. Pathophysiology and treatment of Amanita poisoning are reviewed.
authors.affiliation: Missouri Regional Poison Center, Cardinal Glennon Children's Hospital, St Louis, MO, USA. Manu.Madhok@childrenshc.org
authors.forename: Manu
authors.initials: M
authors.lastname: Madhok
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Scalzo
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Blume
authors.forename: Brent A
authors.initials: BA
authors.lastname: Neuschwander-Tetri
authors.forename: Julie A
authors.initials: JA
authors.lastname: Weber
authors.forename: Michael W
authors.initials: MW
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000545:Amanita; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D009145:Mushroom Poisoning / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index