The characteristics of liver injury induced by Amanita and clinical value of α-amanitin detection

作     者：Li-Ying Lin Ya-Ling Tong Yuan-Qiang Lu Li-Ying Lin;Ya-Ling Tong;Yuan-Qiang Lu

作者机构：Department of Emergency Medicinethe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China The Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang ProvinceHangzhou 310003China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2022年第21卷第3期

页      面：257-266页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：This project was supported by a grant from the Foundation of Key Discipline Construction of Zhejiang Province for Traditional Chinese Medicine (2017-XKA36) 

主　　题：Mushroom poisoning α-amanitin Detection Acute liver failure Early diagnosis and intervention 

摘      要：Background:Amanita poisoning as a foodborne disease has raised concerning mortality *** the interval between mushroom ingestion and medical intervention could greatly influence the outcomes of Amanita poisoning patients,while treatment is highly dependent on a confirmed *** this end,we developed an early detection-guided intervention strategy by optimizing diagnostic process with performingα-amanitin detection,and further explored whether this strategy influenced the progression of Amanita ***:This study was a retrospective analysis of 25 Amanita poisoning *** patients in the detection group were diagnosed mainly based onα-amanitin detection,and 12 patients were diagnosed essentially on the basis of mushroom consumption history,typical clinical patterns and mushroom identification(conventional group).Amanita poisoning patients received uniform therapy,in which plasmapheresis was executed once confirming the diagnosis of Amanita *** compared the demographic baseline,clinical and laboratory data,treatment and outcomes between the two groups,and further explored the predictive value ofα-amanitin concentration in ***:Liver injury induced by Amanita appeared worst at the fourth day and alanine aminotransferase(ALT)rose higher than aspartate aminotransferase(AST).The mortality rate was 7.7%(1/13)in the detection group and 50.0%(6/12)in the conventional group(P=0.030),since patients in the detection group arrived hospital much earlier and received plasmapheresis at the early stage of *** early detection-guided intervention helped alleviate liver impairment caused by Amanita and decreased the peak AST as well as ***,the predictive value ofα-amanitin concentration in serum was still considered ***:In the management of mushroom poisoning,consideration should be given to the rapid detection ofα-amanitin in suspected Amanita poisoning patients and the immediate initiation of medi