MONITORING OF HEMOSTATIC PARAMETERS IN 5 CASES OF AMANITA-PHALLOIDES POISONING

The effects of Amanita phalloides poisoning on haemostatic parameters were determined in five members of two families with particular attent ion to coagulation inhibitors. According to the prothrombin time and f actor V level, one patient had severe poisoning, one moderate and the other three had only mild toxicity. The decrease of inhibitors (antith rombin III, proteins C and protein S) was not followed by coagulation activation as assessed by the moderate increase in D-dimers and the ab sence of a clinically significant coagulopathy. Antithrombin III showe d little decrease, except in the more severely affected case and prote in C paralleled the decrease in factor VII, but to a lesser extent. Th e decrease in coagulation factors and inhibitors could not be explaine d by their half-lives alone. Factor V was a better indicator of the re covery of liver synthesis function than other factors. Our observation s indicate that monitoring coagulation inhibitors in Amanita poisoning is not more informative than prothrombin time and coagulation factor V, both usually recognized as early prognostic markers of fulminant he patic failure.