Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, No. 1 Xinmin Street, 130021, Changchun, Jilin, China.
BMC Pediatr. 2020 Jul 23;20(1):351. doi: 10.1186/s12887-020-02249-9.
Pediatric acute liver failure is a rare, life-threatening illness. Mushroom poisoning is a rare etiology. For patients with irreversible pediatric acute liver failure, liver transplantation is the ultimate lifesaving therapy. However, it is difficult to determine the optimal timing of transplantation. Here, we present a case of pediatric acute liver failure due to mushroom poisoning in northeastern China. He was treated with liver transplantation and recovered. To our knowledge, there are few reports about liver transplantation for pediatric acute liver failure caused by mushroom poisoning in mainland China.
The patient was a previously healthy 9-year-old boy who gradually developed nausea, vomiting, jaundice and coma within 5 days after ingesting mushrooms. He was diagnosed with mushroom poisoning and acute liver failure. He was treated with conservative care but still deteriorated. On the 7th day after poisoning, he underwent LT due to grade IV hepatic encephalopathy. Twenty days later, he recovered and was discharged. A review of the literature revealed that the specific criteria and optimal timing of transplantation remain to be determined.
Patients with pediatric acute liver failure should be transferred to a center with a transplant unit early. Once conservative treatment fails, liver transplantation should be performed.
小儿暴发性肝衰竭是一种罕见的、危及生命的疾病。蘑菇中毒是一种罕见的病因。对于不可逆的小儿暴发性肝衰竭患者，肝移植是最终的救命治疗方法。然而，确定移植的最佳时机很困难。在这里，我们报告了一例中国东北地区因蘑菇中毒导致的小儿暴发性肝衰竭病例。他接受了肝移植治疗并康复。据我们所知，在中国内地，关于蘑菇中毒导致小儿暴发性肝衰竭行肝移植的报道很少。
患儿为 9 岁健康男孩，在摄入蘑菇后 5 天逐渐出现恶心、呕吐、黄疸和昏迷。他被诊断为蘑菇中毒和急性肝衰竭。他接受了保守治疗，但病情仍在恶化。在中毒后第 7 天，他因 4 级肝性脑病行 LT。20 天后，他康复出院。文献复习发现，移植的具体标准和最佳时机仍有待确定。
小儿暴发性肝衰竭患者应尽早转至有移植单位的中心。一旦保守治疗失败，应行肝移植。
