Profile of alkaline phosphatase isoenzymes in ten patients poisoned by mushrooms of the genus Lepiota.

Mushrooms of the genus Lepiota (helveola and bruneo-incarnata), similar to those of the genus Amanita, contain amatoxins. Amatoxins, especially amanitin, cause cellular destruction by inhibiting RNA polymerase. Due to the hepatic toxicity of these mushrooms, we have assessed their incidence on alkaline phosphatase levels and on its isoenzymes. Total alkaline phosphatase activity levels were not found to be increased except in two patients, and then only moderately. As regards isoenzymes, the occurrence of a double hepatic fraction in five of the 10 patients, is the most remarkable finding. There seems to exist a relatively close correspondence between the occurrence of a hepatic2 fraction correlating with those of urine amanitin. We conclude that the hepatic2 fraction proves to be important in assessing liver damage by mushroom poisoning because of its correlation with the patient's degree of poisoning.