Management of Amanita phalloides poisoning: A literature review and update

J Crit Care. 2018 Aug:46:17-22. doi: 10.1016/j.jcrc.2018.03.028. Epub 2018 Mar 28.

Abstract

Amanita phalloides poisoning with a high mortality is a serious health problem in the world. The typical clinical manifestations are usually characterized by the absence of any symptoms followed by severe gastrointestinal disorders and acute liver failure. Inhibition of RNA polymeraseII (RNAP II) activity, apoptosis, and oxidative stress are considered as the major mechanism of amatoxins intoxication. The current treatment measures mainly include prevention of amatoxins absorption, elimination of absorbed amatoxins, potential antidotes therapy, and liver transplantation. Nevertheless, there are no widely accepted treatment criteria for Amanita phalloides poisoning. This paper will focus on the treatment measures based on the previous studies and provide the currently available information for clinicians.

Keywords: Acute liver failure; Amanita phalloides poisoning; Therapeutics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acetylcysteine / therapeutic use
  • Amanita*
  • Amanitins / adverse effects*
  • Antidotes / therapeutic use
  • Bile Ducts / drug effects
  • Charcoal / therapeutic use
  • Diuresis
  • Gastric Lavage
  • Humans
  • Liver / drug effects*
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / surgery
  • Liver Transplantation
  • Mushroom Poisoning / epidemiology
  • Mushroom Poisoning / therapy*
  • Penicillin G / therapeutic use
  • Silymarin / therapeutic use

Substances

  • Amanitins
  • Antidotes
  • Silymarin
  • Charcoal
  • amatoxin
  • Penicillin G
  • Acetylcysteine