Aminotransferases as markers in Amanita phalloides poisonings

• Published in: Journal of toxicology. Clinical toxicology 2003-08, Vol.41 (5), p.720-720
• Main Authors: Petkovska, L, Pereska, Z, Naumovski, J, Bozinovska, C, Naumov, I, Babulovska, A
• Format: Article
• Language: English
• ISSN: 0731-3810

Toxic hepatitis is the major toxic effect in Amanita phalloides mushroom poisonings. Elevated aspartate (AST) and alanine aminotransferase (ALT) are very sensitive markers for hepatocellular damage. We examined the relationship between aminotransferases (transaminases) levels during hospital treatment, and the severity of poisoning and clinical outcome, in phalloid intoxications. We retrospectively evaluated the medical records of 14 inpatients with phalloid poisoning, with emphasis on their aminotransferases levels, clinical course, and outcome. Patients were divided into two groups: four (28.5%) patients with lethal outcome, and 10 (71.5%) who survived. Increased aminotransferases levels were generally noted on the second day following ingestion. After this initial elevation they rose to their highest average level on the 5th day. In the lethal outcome group the mean of the highest AST values was 2053 U/L (198-5366), while that of ALT was 1446 (277-3330). In the second group the mean of the highest AST values was 335 (22-661), while that of ALT was 812 (22-2421). Aminotransferases are important and suitable markers for the clinical course and outcome in Amanita phalloides poisonings, just like they are in poisonings with other toxic agents. They are particularly good markers for hepatotoxicity in phalloid poisonings and should be used in conjunction with other clinico-biochemical parameters when assessing intoxication severity and classifying cases.