MUSHROOM POISONING INDUCED ACUTE LIVER FAILURE WITH DERANGED COAGULATION PROFILE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 66
Abstract
BACKGROUND Mushroom poisoning cases are frequently reported from Upper Assam during the monsoon season with varying but high mortality. Most of the cases reported from upper Assam are amatoxin poisoning. In one of our previous publications we have concluded that raised serum bilirubin, unconjugated bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were predictors of mortality. In this case series, we report 14 cases that came in the early spring of 2017 and we found that raised prothrombin time was a strong indicator of mortality in patients with mushroom poisonings. MATERIALS AND METHODS All patients who came to our Institute in 2017 with alleged history of mushroom poisoning were included in our study. A detailed history was taken and proper clinical examinations were done. Biochemical tests were done and correlated with patient’s outcome. All patients were treated according to our Institutional protocol. RESULTS Fourteen (14) adults were included in the series with eight (8) males and six (6) females. Four (4) patients expired and ten (10) survived. The patients who died had significant high liver enzymes. They also had significantly higher prothrombin time (mostly above 50 seconds), whereas in those patients who survived their average prothrombin time was 15.9 seconds initially (on day two of ingestion of mushroom) and 11.7 seconds during recovery (day eight of ingestion of mushroom). CONCLUSION We conclude that high Prothrombin time, especially more than 50 seconds, is associated with high mortality in patients with mushroom poisoning
Authors and Affiliations
Anupama Dutta, Pranjal Kumar Dutta, Swarup Kar
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