Buradasınız

Anasayfa » Content

Mantar Zehirlenmesi Olgularımızın Klinik, Laboratuvar ve Prognostik Değerlendirilmeleri

Clinical, Laboratory and Prognosis Evaluations of Our Mushroom Poisoning Cases

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
DOI 10.5262/tndt.2013.1001.06

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
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.
Bookmark/Search this post with
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.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_22_pp_45-51.pdf
  • 1
45-51
  • Turkish

REFERENCES

References: 

1. Dökmeci İ: Mushroom poisoning. Dökmeci İ (ed): Toxicology.
Diagnosis and Treatment at Acute Poisonings (2nd ed). İstanbul:
Nobel Tıp Kitabevi, 1994; 465
2. Evrenkaya TR, Atasoyu EM: Extracorporal therapies at mushroom
poisonings. Turk Neph Dial Transpl 2001; 10 (1): 14-18
3. Ergüven M, Cakı S, Deveci M: Mushroom poisoning: Evaluation
of 28 cases. Journal of Pediatric Health and Diseases 2004; 47(4):
249-253
4. Ozdemir IK, Duger C, Gonullu M: The evaluation of mushroom
poisoning cases treated in intensive care. Journal of Cumhuriyet
University Faculty of Medicine 2004; 26(3): 119-122
5. Berger KJ, Guss DA: Mycotoxins revisited: Part I. J Emerg Med
2005; 28(1): 53-62
6. Diaz JH: Syndromic diagnosis and management of confirmed
mushroom poisonings. Crit Care Med 2005; 33(2): 427-436
7. Tintinalli JE, Kelen GD, Stapczynski JS: Emergency Medicine
Comprehensive Study Guide (1st ed). İstanbul: AND Danışmanlık
Yayınları, 2002; 645-651
8. Onat T: Pediatric Health and Diseases (1st ed). İstanbul: Eksen
Publishing, 1996; 1050-1051
9. Dökmeci İ: Mushroom poisoning. Dökmeci İ, ed. Toksicology.
Diagnosis and Treatment at Acute Poisonings (3rd ed). İstanbul:
Nobel Medical Science Bookstore, 2001; 567-616
10. Pajoumand A, Shadnia S, Efricheh H, Mandegary A, Hassanian-
Moghadam H, Abdollahi M: A retrospective study of mushroom
poisoning in Iran. Hum Exp Toxicol 2005; 24(9): 609-613
11. Ishihara Y, Yamaura Y: Descriptive epidemiology of mushroom
poisoning in Japan. Nippon Eiseigaku Zasshi 1992; 46(6):
1071-1078
12. Unluoglu I, Tayfur M: Mushroom poisoning: An analysis of the data
between 1996 and 2000. Eur J Emerg Med 2003; 10(1): 23-26
13. Unluoglu I, Alper Cevik A, Bor O, Tayfur M, Sahin A: Mushroom
poisonings in children in Central Anatolia. Vet Hum Toxicol 2004;
46(3): 134-137
14. Ecevit Ç, Hızarcıoğlu M, Gerçek PA, Gerçek H, Kayserili E, Gülez
P, Apa H: A retrospective study of mushroom poisonings recourse
to the emergency services. Journal of AD University Faculty of
Medicine 2004; 5(3): 11-14
15. Araz C, Karaaslan P, Esen A, Zeyneloglu P, Candan S, Torgay A,
Haberal M: Successful treatment of a child with fulminant liver
failure and coma due to Amanita phalloides poisoning using urgent
liver transplantation. Transplant Proc 2006; 38(2): 596-597
16. Aggarval P, Wali J: Environmental toxins: Mushrooms. In: Diagnosis
& Management of Common poisonings. Oxford University Press;
1997; 384-388
17. Tegzes JH, Puschner B: Toxic mushrooms. Vet Clin North Am
Small Anim Pract 2002; 32(2): 397-407
18. Krenová M, Pelclová D, Navrátil T: Survey of Amanita phalloides
poisoning: Clinical findings and follow-up evaluation. Hum Exp
Toxicol 2007; 26(12): 955-961
19. Enjalbert F, Rapior S, Nouguier-Soule J, Guillon S, Amouroux N,
Cabot J: Treatment of amatoxin poisoning: 20-year retrospective
analysis. J Toxicol Clin Toxicol 2000; 40 (6): 715–757
20. Durukan P, Yıldız M, Cevik Y, Ikizceli I, Kavalci C, Celebi S.
Poisoning from wild mushrooms in Eastern Anatolia region:
Analyses of 5 years. Hum Exp Toxicol 2007; 26(7): 579-582
21. Klein AS, Hart S, Brems SS, Goldstein L, Lewin K, Busuttil RW:
Amanita poisoning: Treatment and the role of liver transplantation.
Am J Med 1989; 86(1): 187-193
22. Kayaalp O: Rational therapy in the medical pharmacology (7. ed).
Ankara: Feryal Typography, 1990; 2201-2206
23. Butera R, Locatelli C, Petrolini V, Lonati D, Bernareggi G,
Manzo L: Treatment of amatoxin poisoning with intravenous
acetylcysteine: Clinical results. Programme and abstracts from the
XXIV. International congress EAPCCT-Strasbourg (France), June
1–4, 2004. J Toxicol Clin Toxicol 2004; 42 (4):460-461 (Abstract)
24. Czygen P, Stiehl A, Kommerel B. Treatment of acute Amanita
phalloides induced hepatic failure by haemoperfusion. In: Faulstich
H, Kommerel B, Wieland T (eds). Amanita Toxins and Poisoning.
Gerhard: Witzstrock Baden-Baden, Verlag, 1980; 155-158
25. Bartels O, Topff G: Amanita phalloides poisoning: Indication for
early haemoperfusion. In: Faulstich H, Kommerel B, Wieland T
(eds). Amanita Toxins and Poisoning. Gerhard, Witzstrock Baden-
Baden, Verlag, 1980; 147-154
26. Aji DY, Calişkan S, Nayir A, Mat A, Can B, Yaşar Z, Ozşahin H,
Cullu F, Sever L: Haemoperfusion in Amanita phalloides poisoning.
J Trop Pediatr 1995; 41(6): 371-374
27. Monhart V: Amanita poisoning and the importance of sorption
hemoperfusion in its therapy. Vnitr Lek 1997; 43(10): 686-690
28. Eren ŞH, Oğuztürk H, Korkmaz İ, Varol O: The evaluation of
mushroom poisoning cases recourse to Cumhuriyet University
Faculty of Medicine, Emergency Medicine Department in 2004.
Journal of Cumhuriyet University Faculty of Medicine 2005; 27(1):
15-18
29. Oldridge SG, Pegler DN, Spooner BM: Wild mushroom and
Toadstool Poisoning, Royal Botanic Gardens, Kew 1989
30. Işıloğlu M, Gücin F, Mat A: Mushroom poisonings occure in
İstanbul, in November 1994. Journal of Ecology & Environment
1995; 14(1): 22-28
31. Öntürk YA, Uçar B: A retrospective study of childhood poisonings
in Eskişehir region. Journal of Pediatric Health and Diseases 2003;
46(2): 103-113
32. Akköse AŞ, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O: Adult
poisoning cases between 1996 and 2004. Journal of Uludağ
University Faculty of Medicine 2006; 32(1): 25-27
33. Bilir A, Yelken B, Ekemen S, Zeydanoğlu S: Retrospective
evaluation of mushroom intoxication cases. Turkiye Klinikleri J
Anest Reanim 2006;4(3):131-134

Thank you for copying data from http://www.arastirmax.com