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Mantar Zehirlenmesi Olgularımızın Klinik, Laboratuvar ve Prognostik Değerlendirilmeleri

Clinical, Laboratory and Prognosis Evaluations of Our Mushroom Poisoning Cases

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DOI: 
DOI 10.5262/tndt.2013.1001.06

Keywords (Original Language):

Abstract (2. Language): 
OBJECTIVE: Mushroom poisoning may cause diverse clinical presentations ranging from mild gastrointestinal symptoms to fulminant hepatic failure requiring liver transplantation. It may lead to high mortality if not intervened. Toxic wild mushrooms usually grow up in spring and autumn and poisoning by these mushrooms occur mostly in these seasons. The aim of this study was to evaluate demographics, clinical features and prognosis in a large mushroom poisoning case series. MA TERIAL and M ETHODS: In this study, the demographics, clinical and laboratory findings, treatment methods and prognosis of 84 mushroom poisoning cases were evaluated retrospectively from their medical records. RESUL TS: The mean age of the 84 cases (52 women, 32 men) was 39.8 ± 13.4 years. The main complaints upon admission were recorded as nausea-vomiting (80%), diarrhea (64%), abdominal pain (40%), and dizziness (20%). Twenty-five patients were applied hemoperfusion due to renal and hepatic failure. A case died of renal and hepatic failure. The mean of hospitalization was 6.3 ± 5.6 days. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), INR, and urea values had decreased significantly at the time of hospital discharge compared to baseline values (P < 0.001); however, no statistically significant difference existed between baseline and discharge creatinine levels (P > 0.05). CONCLU SION: In our study, it was observed that early hemoperfusion provided better prognosis by enhancing the efficacy of the treatment. However, the best method to reduce the mortality is to enlighten the community about the risks of mushroom poisonings.
Abstract (Original Language): 
AMA Ç: Mantar zehirlenmesi hafif gastrointestinal semptomlardan karaciğer transplantasyonu gerektiren fulminan hepatik yetmezliğe uzanan farklı klinik sergilenmeler ortaya koyabilir. Eğer müdahale edilmezse yüksek mortaliteye neden olabilir. Zehirli yabani mantarlar genellikle ilkbahar ve sonbaharda yetişir ve bu mantar zehirlenmeleri daha çok bu mevsimlerde olur. Bu çalışmanın amacı, geniş bir mantar zehirlenmesi olgu serisinde demografik, klinik özellikleri ve prognozu değerlendirmekti. GEREÇ ve YÖN TEML ER: Bu çalışmada, 84 mantar zehirlenmesi olgusunun demografik, klinik ve laboratuvar bulguları, tedavi yöntemleri ve prognozu tıbbi kayıtlardan retrospektif olarak değerlendirildi. BUL GULA R: 84 olgunun (52 kadın, 32 erkek) ortalama yaşı 39,8 ± 13,4 yıl idi. Başvuru sırasında olan ana şikayetler bulantı-kusma (%80), diyare (%64), karın ağrısı (%40), ve sersemlik (%20) olarak kaydedildi. 25 hastaya renal ve hepatik yetmezlik nedeniyle hemoperfüzyon uygulandı. Bir vaka renal ve hepatik yetmezlik nedeniyle öldü. Ortalama hastaneye yatış süresi 6,3 ± 5,6 gündü. Alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), protrombin zamanı (PT), INR ve üre değerleri hastaneden taburcu esnasında bazal değerlere göre anlamlı olarak azalmıştı. (P < 0,001); fakat bazal ve taburculuk kreatin değerleri arasında anlamlı istatistiksel farklılık mevcut değildi (P > 0,05). SONU Ç: Bizim çalışmamızda, erken hemoperfüzyonun tedavi etkinliğini arttırarak daha iyi prognoz sunduğu gözlemlendi. Fakat mortaliteyi azaltmak için en iyi yöntem mantar zehirlenmesinin riskleri ile ilgili toplumu aydınlatmaktır.
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