Effects of interrupting the enterohepatic circulation in amatoxin intoxications

Interruption of the enterohepatic circulation is regarded as an effective way to treat patients with amatoxin poisoning. Nonetheless, its effectiveness has not yet been systematically evaluated. Therefore, we performed a systematic review to investigate the role of enterohepatic circulation on patie...

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Bibliographic Details
Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2024-02, Vol.62 (2), p.69-75
Main Authors: Varekamp, Jurriaan, Tan, Jia Lin, Stam, Janine, van den Berg, Aad P, van Rheenen, Patrick F, Touw, Daan J, Dekkers, Bart G J
Format: Article
Language:English
Subjects:
Amanitins
Charcoal - therapeutic use
Enterohepatic Circulation
Humans
Liver
Mushroom Poisoning - diagnosis
Mushroom Poisoning - drug therapy
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Summary:Interruption of the enterohepatic circulation is regarded as an effective way to treat patients with amatoxin poisoning. Nonetheless, its effectiveness has not yet been systematically evaluated. Therefore, we performed a systematic review to investigate the role of enterohepatic circulation on patient outcome and clinical laboratory values. We specifically sought to evaluate the effect of activated charcoal, which absorbs drugs and toxins in the gastrointestinal tract. A previously established database with data extracted from case reports and series from literature, supplemented with recent publications, was used. Patient characteristics, outcome, and laboratory values were evaluated. We included 133 publications describing a total of 1,119 unique cases. Survival was 75 per cent in the control group (  = 452), whereas in the group treated with single or multiple doses of activated charcoal (  = 667) survival was 83 per cent (  
ISSN:1556-3650
1556-9519
DOI:10.1080/15563650.2024.2312182