Ramirez P, Parrilla P, Sanchez Bueno F, Robles R, Pons J A, Bixquert V, Nicolas S, Nuñez R, Alegria M S, Miras M
Department of Surgery, Virgen de la Arrixaca University hospital, Murcia, Spain.
J Hepatol. 1993 Aug;19(1):51-4. doi: 10.1016/s0168-8278(05)80175-8.
We present ten patients who suffered from a cyclopeptide syndrome from two different foci, one caused by Lepiota helveola (seven cases) and the other by Lepiota brunneoincarnata (three cases). Of the ten victims, five recovered completely after the intestinal stage and the other five developed a phase of visceral involvement with alterations of liver function. In two patients, hepatic function became normal after the 7th day after ingestion. Three patients developed fulminant hepatitis and two of these died of adult respiratory distress syndrome. The fulminant hepatitis patient who later improved developed active chronic hepatitis 1 year later. Finally, five patients developed mixed polyneuropathy. In this paper the indications for orthotopic liver transplant (OLTx) are discussed and the development of late complications such as active chronic hepatitis and mixed polyneuropathy are considered.
我们报告了10例来自两个不同病灶的环肽综合征患者，其中7例由浅黄环柄菇引起，3例由褐肉环柄菇引起。10名受害者中，5例在肠道期后完全康复，另外5例进入内脏受累阶段，出现肝功能改变。2例患者在摄入后第7天肝功能恢复正常。3例患者发展为暴发性肝炎，其中2例死于成人呼吸窘迫综合征。后来病情好转的暴发性肝炎患者1年后发展为活动性慢性肝炎。最后，5例患者出现混合性多发性神经病。本文讨论了原位肝移植（OLTx）的适应证，并考虑了晚期并发症如活动性慢性肝炎和混合性多发性神经病的发生情况。
