title: Usefulness of 13C-methacetin breath test in liver function testing in Amanita phalloides poisoning; breast feeding woman case.
abstract: BACKGROUND
  Mortality from ingestion of the mushroom Amanita phalloides still remains as high as 8-10%. In critical patients, liver dialysis can bridge the patient to liver transplantation, which may be a lifesaving procedure. We report the use of 13C-methacetin breath test (13C-MBT) in monitoring hepatic function in a case of A. phalloides poisoning.
  
  
  METHODS
  A 33-year-old woman ate mushrooms that she had picked. After 8 h, she developed nausea and vomiting, abdominal cramps, and diarrhea, which lasted for another 24 h. On the third day, features of liver injury were seen. Pharmacologic therapy failed and she underwent liver dialysis on days 4 and 5. A 13C-MBT was used to evaluate hepatic functional reserve before the first and after the second dialysis. A liver transplantation on day 6 was successful.
  
  
  CONCLUSIONS
  The breath test results showed that at 40 min after substrate ingestion the mean 13C-MBT cumulative oxidation percentage was 10.5 +/- 3.8% in healthy controls, whereas in our patient this parameter decreased from 0.09% on the fourth day to 0.02% on the fifth day.
  
  
  CONCLUSIONS
  13C-MBT is a simple, non-invasive diagnostic tool which may be useful as a predictor of outcome and as a marker of the severity of liver damage.
authors.affiliation: Department of Toxicology, Jagiellonian University Medical College, Krakow, Poland. piodzik@poczta.onet.pl
authors.forename: Piotr
authors.initials: P
authors.lastname: Hydzik
authors.forename: Władysław
authors.initials: W
authors.lastname: Bielañski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Ponka
authors.forename: Maciej
authors.initials: M
authors.lastname: Wójcicki
authors.forename: Jerzy
authors.initials: J
authors.lastname: Lubikowski
authors.forename: Janusz
authors.initials: J
authors.lastname: Pach
authors.forename: Wiesłan
authors.initials: W
authors.lastname: Pawlik
mesh_terms: D000081:Acetamides; D000328:Adult; D000545:Amanita; D001942:Breast Feeding; D001944:Breath Tests / Q000379:methods; D002247:Carbon Isotopes; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008111:Liver Function Tests / Q000379:methods; D016031:Liver Transplantation; D013058:Mass Spectrometry; D009145:Mushroom Poisoning / Q000150:complications*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D002247:Carbon Isotopes; C035495:methacetin