INTENSIVE HEMODIALYSIS AND HEMOPERFUSION TREATMENT OF AMANITA MUSHROOM POISONING

Over a period of fifteen years, 41 patients including 23 males and 18 females with Amanita mushroom poisoning were treated at the University Hospital of Lund, Sweden. The intensity of poisoning was graded accor ding to serum transaminase elevations and prothrombin time reductions. Severity was mild in 16 patients (Group A), moderate in 14 (Group B) and severe in 11 (Group C). Members of Group C reported shorter latenc y periods before the onset of symptoms, (10 +/- 1 hours, p < 0.05) and longer delays in treatment, (34 +/- 4 hours), than did the other pati ents. Intensive treatment was begun before the results of urine amatox in assays were reported. Treatment consisted of: fluid and electrolyte replacement, oral activated charcoal and lactulose, IV penicillin, co mbined hemodialysis and hemoperfusion in two 8 hour sessions, some rec eived IV thioctic acid, others IV silibinin, all received a special di et. This combination of treatment modalities was used to accelerate th e elimination of amatoxin from the patients' bodies. The longest perio d of hospitalization, 13 +/- 2 days, was required by the patients of G roup C (p < 0.01). All patients improved and were discharged from the hospital asymptomatic. No sequelae were later reported for the majorit y of those moderately and severely poisoned. We have concluded that in tensive combined treatment applied in these cases is effective in reli eving patients with both moderate and severe amanitin poisoning.