Unexpected Amanita phalloides-Induced Hematotoxicity—Results from a Retrospective Study
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Hematological Parameters
3. Discussion
4. Conclusions
5. Materials and Methods
5.1. Study design and patients
5.2. Procedures
5.3. Complications
5.4. Poison Severity Score
5.5. Statistical analysis
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Total | Patients with Acute Liver Failure (ALF) |
---|---|---|
Number of patients | 28 | 6 |
- Male (%) | 16 (57) | 2 (21) |
Age (years)—median (range) | 39 (3–72) | 44 (3–65) |
Origin—number | ||
- Dutch (%) | 7 (25) | 1 (17) |
- Other (%) | 21 (75) | 5 (83) |
Categorization: | ||
- Proven (%) | 0 (0) | 0 (0) |
- Probable (%) | 2 (6) | 0 (0) |
- Possible (%) | 26 (79) | 6 (100) |
Hours between ingestion and hospitalization—median (range) | 27 (15–96) | 28 (17–96) |
Days of hospitalization—median (range) | 8 (2–64) | 15 (2–64) |
ICU admission—number (%) | 8 (29) | 5 (83) |
Liver transplantation—number (%) | 1 (4) | 1 (17) |
Survived—number (%) | 25 (89) | 3 (50) |
Antidotes used—number (%) | ||
- Silibinin | 26 (93) | 6 (100) |
- N-acetylcysteine | 23 (82) | 5 (83) |
- Benzylpenicillin | 10 (36) | 1 (17) |
Complications—number (%) | ||
- Hepatitis | 27 (96) | 6 (100) |
- Anemia | 20 (71) | 6 (100) |
- Lactate acidosis | 10 (36) | 6 (100) |
- Acute kidney injury | 10 (36) | 4 (66) |
- Acute liver failure | 6 (21) | 6 (100) |
- Hypokalemia | 5 (18) | 1 (17) |
- Infection | 5 (18) | 1 (17) |
Laboratory Values | No ALF (n = 22) | ALF (n = 6) |
---|---|---|
At hospitalization | ||
Alanine aminotransferase (ALT, U/L) | 278 (13–4912) | 2197 (62–7192) |
Aspartate aminotransferase (AST, U/L) | 342 (16–9766) | 2246 (83–7285) |
Lactate dehydrogenase (LDH, U/L) | 285 (132–3192) | 3822 (213–6090) |
Bilirubin (μmol/L) | 14 (4–47) | 25 (9–165) |
International normalized ratio (INR) | 1 (1–2) | 2 (1–8) |
Ammonia (μmol/L) | 30 (7–94) | 50 (22–247) |
Creatinine (μmol/L) | 83 (37–483) | 76 (15–286) |
Blood urea nitrogen (BUN, mmol/L) | 7 (2–29) | 6 (2–23) |
Lactate (mmol/L) | 2 (1–5) | 4 (2–10) |
Maximum value during hospitalization | ||
Alanine aminotransferase (ALT, U/L) | 4539 (158–10,904) | 7318 (4414–14,500) |
Aspartate aminotransferase (AST, U/L) | 3070 (90–10,444) | 6045 (3748–12,543) * |
Lactate dehydrogenase (LDH, U/L) | 2089 (161–9206) | 4740 (2280–9527) * |
Bilirubin (μmol/L) | 55 (15–269) | 271 (94–420) ** |
International normalized ratio (INR) | 2 (1–6) | 10 (7–10) *** |
Ammonia (μmol/L) | 57 (30–133) | 242 (113–561) *** |
Creatinine (μmol/L) | 88 (47–1269) | 191 (23–286) |
Blood urea nitrogen (BUN, mmol/L) | 8 (3–29) | 12 (6–35) |
Lactate (mmol/L) | 2 (1–6) | 12 (5–22) *** |
Poison Severity Score (PSS) | ||
At hospitalization | 4 (1–8) | 5 (3–10) |
Maximum value during hospitalization | 6 (2–9) | 10 (8–12) *** |
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Visser, M.; Hof, W.F.J.; Broek, A.M.; van Hoek, A.; de Jong, J.J.; Touw, D.J.; Dekkers, B.G.J. Unexpected Amanita phalloides-Induced Hematotoxicity—Results from a Retrospective Study. Toxins 2024, 16, 67. https://doi.org/10.3390/toxins16020067
Visser M, Hof WFJ, Broek AM, van Hoek A, de Jong JJ, Touw DJ, Dekkers BGJ. Unexpected Amanita phalloides-Induced Hematotoxicity—Results from a Retrospective Study. Toxins. 2024; 16(2):67. https://doi.org/10.3390/toxins16020067
Chicago/Turabian StyleVisser, Miranda, Willemien F. J. Hof, Astrid M. Broek, Amanda van Hoek, Joyce J. de Jong, Daan J. Touw, and Bart G. J. Dekkers. 2024. "Unexpected Amanita phalloides-Induced Hematotoxicity—Results from a Retrospective Study" Toxins 16, no. 2: 67. https://doi.org/10.3390/toxins16020067