Early Hydration Therapy in Mushroom Poisoning Improves Mortality and Morbidity

Dutta, Anupam; Das, Anup Kumar; Pegu, Ajit Kumar; Kalita, Bipul Chandra

doi:10.31736/jist/v14.i1.2018.11-16

Cited by 2 publications

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“…[ 32 33 34 35 ] Recent studies have also shown significant reduction in mortality among fulminant hepatitis patients based on early aggressive hydration therapy of 4 L over 24 h and administration of antioxidant N-acetyl cysteine with the continuation of supportive therapy compared to cohorts of older patients who did not receive such treatment. [ 36 37 ] We also noted that climate plays an important role in the growth of these wild poisonous mushrooms. Rainfall, temperature, and humidity are the factors influencing the growth of wild mushrooms, as shown in Figure 5 .…”

Section: Discussionmentioning

confidence: 91%

Delayed liver toxicity and delayed gastroenteritis

Tiewsoh

Bhattacharya

Barman

et al. 2022

Journal of Family Medicine and Primary Care

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Introduction: Mushroom poisoning occurs from consumption of the wild variants of mushroom containing varied forms of toxins. Among those toxins, amatoxin containing mushrooms are known for the significant morbidity and mortality from hepatic toxicity and delayed gastroenteritis. Although not a very common cause of poisoning, it is prevalent in the north-eastern region of India, especially during the rainy summer seasons when the wild variants are found abundantly and often confused with the edible variants. Aims and Objectives: To study the clinical and biochemical profiles and short term outcomes of patients with mushroom poisoning admitted to a tertiary care hospital. Materials and Methods: We analyzed the data of patients with mushroom poisoning admitted to a tertiary care institute in north-eastern India between January 2015 to December 2020 to study their clinical and biochemical profiles, and short-term outcomes. Their clinical features, biochemical parameters, management, and in-hospital outcomes were noted. All data was recorded in Microsoft MS Excel and analyses done using SPSS version 22. Results: Of the 44 patients with mushroom poisoning, 23 (52%) were male and 21 (47%) were female, with a mean age of 20.13 years. Seventeen patients (38%) had delayed liver failure and delayed gastroenteritis, 19 patients (43%) had acute gastroenteritis syndrome, 5 patients (11%) had cholinergic symptoms, one patient (2%) each had acute kidney injury and a disulfiram-type reaction with headache. The mean hospital stay of the patients was 5 days. In-hospital mortality occurred in 10 (58%) patients with delayed liver failure and none of the patients with the other complications died. Conclusion: This study revealed a high prevalence of mushroom poisoning that caused delayed liver toxicity and delayed gastroenteritis, probably amatoxin-induced, which is fatal, thus accounting for high mortality and poor outcomes in these patients.

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Section: Discussionmentioning

confidence: 91%

Delayed liver toxicity and delayed gastroenteritis

Tiewsoh

Bhattacharya

Barman

et al. 2022

Journal of Family Medicine and Primary Care

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“…In a couple of studies done in Assam, the mortality was 13.82% and 14.7%, respectively. 18,22 In a study conducted in Turkey, the mortality was 1.02% and, in another study, done in Iran, the mortality was 12%. 19,23 Among the laboratory parameters, liver function was affected in most patients, with the average AST, ALT, and INR being 247.63 IU/l, 309.14 IU/l, and 2.35, respectively.…”

Section: Discussionmentioning

confidence: 97%

“…17 In our study, gastrointestinal symptoms such as loose stool, vomiting, pain abdomen, diarrhoea, and jaundice were the most common symptoms, and the other features were coagulopathy, hypotension and renal failure, which is similar to those reported in other studies done in India and abroad. [18][19][20][21] The mortality of patients with mushroom toxicity varies with geographical distribution. In our study, the mortality was 28.6%.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of patients presenting with mushroom toxicity in a tertiary care setup in Northeast India: with special focus on model for end-stage liver disease score as a predictor of disease outcome

et al. 2023

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Background: Ingestion of wild mushrooms leading to toxicity is a common phenomenon every year during the rainy season in Upper Assam, India. The model for end-stage liver disease (MELD) score was developed to predict mortality in a specific group of patients with decompensated chronic liver disease. It has also been used to predict mortality in patients with acute liver failure, which is also one of the dreaded complications of mushroom toxicity. There are only a couple of studies in the world that have studied MELD score as a predictor of outcomes in patients with mushroom toxicity and to the best of our knowledge, this is the first such study done in India. Methods: In this hospital-based observational study, 35 patients aged >13 years with an alleged history of ingestion of wild mushrooms, but no other cause of hepatic dysfunction were included in this study. Disease outcome (discharged/expired) was correlated with both MELD score and day of presentation from symptom onset. Results: The mean age was 32.54 years with a male-to-female sex ratio of 4:5 among the study participants. Gastrointestinal symptoms, including loose stool, vomiting, pain abdomen, and jaundice, were the most common. The MELD score was significantly higher in patients who succumbed to the toxin (p<0.05) and positively correlated with mortality (r=0.664, p<0.001) and a later day of presentation (r=0.226, p=0.123). A later-day presentation also positively correlated with mortality (r=0.227, p=0.189). Conclusions: The MELD score can be used as a prognostic tool in patients with mushroom toxicity.

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Early Hydration Therapy in Mushroom Poisoning Improves Mortality and Morbidity

Cited by 2 publications

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Delayed liver toxicity and delayed gastroenteritis

Delayed liver toxicity and delayed gastroenteritis

Clinical profile of patients presenting with mushroom toxicity in a tertiary care setup in Northeast India: with special focus on model for end-stage liver disease score as a predictor of disease outcome

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