phalloidine and Acute-Disease

Acute liver failure is a rare disease that can cause death in the majority of untreated cases. Sudden loss of liver function in the absence of a preexisting liver disease is considered the true form and has to be distinguished from impaired function following exacerbation of an underlying liver disease (acute or chronic failure). Common causes include acute viral hepatitis, drug induced liver injury (DILI) and toxins. The loss of the excretory and synthetic function of the liver marks the clinical presentation and results in icterus, coagulopathy and encephalopathy. Additionally impairment of renal function and sepsis occur and contribute to the high mortality of this disease. The activation of cell death mechanisms (apoptosis) leading to a reductio of viable, functional liver tissue is considered to be an important pathophysiologic mechanism. Curative therapy of this disease includes liver transplantation that has been performed in Germany for the first time in 1969. In the year 2004 a total of 91 liver transplantation were performed for acute liver failure (10.3% of all transplants) in German transplant centers.

Topics: Acute Disease; Adolescent; Adult; Amanita; Anti-Bacterial Agents; Antidotes; Child, Preschool; Drug-Related Side Effects and Adverse Reactions; Germany; Hepatic Encephalopathy; Hepatitis A; Hepatitis B; Hepatitis C; Hepatitis D; Hepatitis E; Hepatocytes; Humans; Liver Failure, Acute; Liver Transplantation; Mushroom Poisoning; Phalloidine; Plasmapheresis; Prognosis; Renal Dialysis; Renal Insufficiency; Substance-Related Disorders

Topics: Acute Disease; Amanita; Amanitins; Child, Preschool; Gallbladder; Humans; Male; Mushroom Poisoning; Phalloidine; Ultrasonography

The phalloidine mushroom poisoning is an exogenic intoxication with specific action of the mushroom toxins on the liver and its functions. The dynamic follow up of serum cholinesterase activity in patients with phalloidine intoxication revealed that it was significantly decreased in the patients who died in comparison to those who survived. In the patients who survived and recovered the serum cholinesterase was moderately decreased and later increased. As a protein product synthesized in the liver the serum cholinesterase is a good marker of the protein-synthesizing function of the liver in patients with phalloidine intoxication and may be used as a prognostic test for its outcome.

Topics: Acute Disease; Adolescent; Adult; Cholinesterases; Clinical Enzyme Tests; Humans; Middle Aged; Mushroom Poisoning; Oligopeptides; Phalloidine; Prognosis; Time Factors