Fulminant Hepatic Failure Caused by Amanita phalloides Toxicity

Mycetism: A Review of the Recent Literature

“…Children are particularly sensitive to amatoxin [14,37,[89][90][91][92]. Toxophallin is an enzyme that induces chromatin condensation, DNA and nucleus fragmentation, and apoptosis.…”

“…Fulminant hepatic failure is characteristic of severe toxicity. Liver pathology is characterized by fatty degeneration and centrilobular necrosis [84,90,94,96]. Acute tubular necrosis, with damage to the proximal tubules, can also be seen [84,85].…”

“…Similarly, some report that plasmapheresis reduces mortality [26,99,118]; others doubt its efficacy [8,32,33]. Liver albumin dialysis [molecular absorbent recirculating system (MARS) or fractionated plasma separation and adsorption with high-flux dialysis (Prometheus)] has been successfully utilized, while awaiting liver transplantation; however, patients may die awaiting organ donation [3,25,31,37,38,83,90,94,[119][120][121].…”

Hepatotoxic Botanicals - An Evidence-based Systematic Review

“…Amatoxincontaining mushrooms like Amanita phalloides can cause sever poisoning leading to death (94). Several cases of Amanita phalloides poisoning have been reported (185,186,188). Thus, the toxicity is due to two toxins, which are phalloidin and α-amanitin.…”

“…The patient was diagnosed with fulminant liver failure and required liver transplantation. In this case, the wild mushroom (A. phalloides) found to contain α-amanitin that induced hepatotoxicity (185). Another case of A. phalloides poisoning involved a 16-year-old female who presented with vomiting, abdominal pain, diarrhea and nausea.…”