Schiødt F V, Ott P, Bondesen S
Medicinsk afdeling A, Rigshospitalet, København.
Ugeskr Laeger. 1995 Jul 31;157(31):4350-4.
In the period 1989-1994 eight patients, who were intoxicated with the mushrooms Amanita phalloides (death cap) or Amanita virosa (deadly agaric) were treated at a Department of Hepatology. All patients had had a symptom free period of more than eight hours before the onset of gastrointestinal symptoms; these symptoms lasting in many cases for several days. All patients had biochemical signs of hepatocellular damage and three patients developed hepatic encephalopathy, fulfilling the criteria for fulminant hepatic failure (FHF). Two died and one patient underwent successful urgent liver transplantation. ALL FHF patients had a prothrombin index below 10% and increased creatine. Antidote treatment with penicillin and silibinine should be given promptly on suspicion of Amanita intoxication and should not await biochemical parameters. Transferral to a hepatological department with access to liver transplantation should be considered if abnormal biochemical liver function develops.
在1989年至1994年期间，肝病科收治了8例因误食毒鹅膏菌（死亡帽）或毒蝇伞（致命伞菌）而中毒的患者。所有患者在出现胃肠道症状之前都有超过8小时的无症状期；这些症状在许多情况下持续数天。所有患者都有肝细胞损伤的生化指标，3例患者出现肝性脑病，符合暴发性肝衰竭（FHF）的标准。2例死亡，1例患者接受了成功的紧急肝移植。所有FHF患者的凝血酶原指数均低于10%，肌酸升高。一旦怀疑是鹅膏菌中毒，应立即给予青霉素和水飞蓟宾解毒治疗，不应等待生化指标。如果出现肝功能异常，应考虑转至有肝移植条件的肝病科。
