Yıl: 2013 Cilt: 22 Sayı: 1 Sayfa Aralığı: 45 - 51 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases

Öz:
AMAÇ: Mantar zehirlenmesi hafif gastrointestinal semptomlardan karaciğer transplantasyonu gerektiren fulminan hepatik yetmezliğe uzanan farklı klinik sergilenmeler ortaya koyabilir. Eğer müdahale edilmezse yüksek mortaliteye neden olabilir. Zehirli yabani mantarlar genellikle ilkbahar ve onbaharda yetişir ve bu mantar zehirlenmeleri daha çok bu mevsimlerde olur. Bu çalışmanın amacı, geniş bir mantar zehirlenmesi olgu serisinde demografik, klinik özellikleri ve prognozu değerlendirmekti. GEREÇ ve YÖNTEMLER: Bu çalışmada, 84 mantar zehirlenmesi olgusunun demografik, klinik ve aboratuvar bulguları, tedavi yöntemleri ve prognozu tıbbi kayıtlardan retrospektif olarak değerlendirildi. BULGULAR: 84 olgunun (52 kadın, 32 erkek) ortalama yaşı 39,8 ± 13,4 yıl idi. Başvuru sırasında olan ana şikayetler bulantı-kusma (%80), diyare (%64), karın ağrısı (%40), ve sersemlik (%20) olarak kaydedildi. 25 hastaya renal ve hepatik yetmezlik nedeniyle hemoperfüzyon uygulandı. Bir vaka enal ve hepatik yetmezlik nedeniyle öldü. Ortalama hastaneye yatış süresi 6,3 ± 5,6 gündü. Alanin minotransferaz (ALT), aspartat aminotransferaz (AST), protrombin zamanı (PT), INR ve üre değerleri hastaneden taburcu esnasında bazal değerlere göre anlamlı olarak azalmıştı. (P < 0,001); fakat bazal ve aburculuk kreatin değerleri arasında anlamlı istatistiksel farklılık mevcut değildi (P > 0,05). SONUÇ: Bizim çalışmamızda, erken hemoperfüzyonun tedavi etkinliğini arttırarak daha iyi prognoz unduğu gözlemlendi. Fakat mortaliteyi azaltmak için en iyi yöntem mantar zehirlenmesinin riskleri ile lgili toplumu aydınlatmaktır.
Anahtar Kelime:

Konular: Cerrahi

Mantar zehirlenmesi olgularımızın klinik, laboratuvar ve prognostik değerlendirilmeleri

Öz:
OBJECTIVE: Mushroom poisoning may cause diverse clinical presentations ranging from mild gastrointestinal symptoms to fulminant hepatic failure requiring liver transplantation. It may lead to high mortality if not intervened. Toxic wild mushrooms usually grow up in spring and autumn and poisoning by these mushrooms occur mostly in these seasons. The aim of this study was to evaluate demographics, clinical features and prognosis in a large mushroom poisoning case series. MATERIAL and METHODS: In this study, the demographics, clinical and laboratory findings, treatment methods and prognosis of 84 mushroom poisoning cases were evaluated retrospectively from their medical records. RESULTS: The mean age of the 84 cases (52 women, 32 men) was 39.8 ± 13.4 years. The main complaints upon admission were recorded as nausea-vomiting (80%), diarrhea (64%), abdominal pain (40%), and dizziness (20%). Twenty-five patients were applied hemoperfusion due to renal and hepatic failure. A case died of renal and hepatic failure. The mean of hospitalization was 6.3 ± 5.6 days. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), INR, and urea values had decreased significantly at the time of hospital discharge compared to baseline values (P < 0.001); however, no statistically significant difference existed between baseline and discharge creatinine levels (P > 0.05). CONCLUSION: In our study, it was observed that early hemoperfusion provided better prognosis by enhancing the efficacy of the treatment. However, the best method to reduce the mortality is to enlighten the community about the risks of mushroom poisonings.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Dökmeci İ: Mushroom poisoning. Dökmeci İ (ed): Toxicology. Diagnosis and Treatment at Acute Poisonings (2nd ed). İstanbul: Nobel Tıp Kitabevi, 1994; 465
  • Evrenkaya TR, Atasoyu EM: Extracorporal therapies at mushroom poisonings. Turk Neph Dial Transpl 2001; 10 (1): 14-18 Ergüven M, Cakı S, Deveci M: Mushroom poisoning: Evaluation of 28 cases. Journal of Pediatric Health and Diseases 2004; 47(4): 249-253
  • Ozdemir IK, Duger C, Gonullu M: The evaluation of mushroom poisoning cases treated in intensive care. Journal of Cumhuriyet University Faculty of Medicine 2004; 26(3): 119-122
  • Berger KJ, Guss DA: Mycotoxins revisited: Part I. J Emerg Med 2005; 28(1): 53-62
  • Diaz JH: Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med 2005; 33(2): 427-436
  • Tintinalli JE, Kelen GD, Stapczynski JS: Emergency Medicine Comprehensive Study Guide (1st ed). İstanbul: AND Danışmanlık Yayınları, 2002; 645-651
  • Onat T: Pediatric Health and Diseases (1st ed). İstanbul: Eksen Publishing, 1996; 1050-1051
  • Dökmeci İ: Mushroom poisoning. Dökmeci İ, ed. Toksicology. Diagnosis and Treatment at Acute Poisonings (3rd ed). İstanbul: Nobel Medical Science Bookstore, 2001; 567-616
  • Pajoumand A, Shadnia S, Efricheh H, Mandegary A, Hassanian- Moghadam H, Abdollahi M: A retrospective study of mushroom poisoning in Iran. Hum Exp Toxicol 2005; 24(9): 609-613
  • Ishihara Y, Yamaura Y: Descriptive epidemiology of mushroom poisoning in Japan. Nippon Eiseigaku Zasshi 1992; 46(6): 1071-1078
  • Unluoglu I, Tayfur M: Mushroom poisoning: An analysis of the data between 1996 and 2000. Eur J Emerg Med 2003; 10(1): 23-26
  • Unluoglu I, Alper Cevik A, Bor O, Tayfur M, Sahin A: Mushroom poisonings in children in Central Anatolia. Vet Hum Toxicol 2004; 46(3): 134-137
  • Ecevit Ç, Hızarcıoğlu M, Gerçek PA, Gerçek H, Kayserili E, Gülez P, Apa H: A retrospective study of mushroom poisonings recourse o the emergency services. Journal of AD University Faculty of Medicine 2004; 5(3): 11-14
  • Araz C, Karaaslan P, Esen A, Zeyneloglu P, Candan S, Torgay A, Haberal M: Successful treatment of a child with fulminant liver failure and coma due to Amanita phalloides poisoning using urgent iver transplantation. Transplant Proc 2006; 38(2): 596-597
  • Aggarval P, Wali J: Environmental toxins: Mushrooms. In: Diagnosis & Management of Common poisonings. Oxford University Press; 1997; 384-388
  • Tegzes JH, Puschner B: Toxic mushrooms. Vet Clin North Am Small Anim Pract 2002; 32(2): 397-407
  • Krenová M, Pelclová D, Navrátil T: Survey of Amanita phalloides poisoning: Clinical findings and follow-up evaluation. Hum Exp Toxicol 2007; 26(12): 955-961
  • Enjalbert F, Rapior S, Nouguier-Soule J, Guillon S, Amouroux N, Cabot J: Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol 2000; 40 (6): 715–757
  • Durukan P, Yıldız M, Cevik Y, Ikizceli I, Kavalci C, Celebi S. Poisoning from wild mushrooms in Eastern Anatolia region: Analyses of 5 years. Hum Exp Toxicol 2007; 26(7): 579-582
  • Klein AS, Hart S, Brems SS, Goldstein L, Lewin K, Busuttil RW: Amanita poisoning: Treatment and the role of liver transplantation. Am J Med 1989; 86(1): 187-193
  • Kayaalp O: Rational therapy in the medical pharmacology (7. ed). Ankara: Feryal Typography, 1990; 2201-2206
  • Butera R, Locatelli C, Petrolini V, Lonati D, Bernareggi GManzo L: Treatment of amatoxin poisoning with intravenous acetylcysteine: Clinical results. Programme and abstracts from the XXIV. International congress EAPCCT-Strasbourg (France), June 1–4, 2004. J Toxicol Clin Toxicol 2004; 42 (4):460-461 (Abstract)
  • Czygen P, Stiehl A, Kommerel B. Treatment of acute Amanita phalloides induced hepatic failure by haemoperfusion. In: Faulstich H, Kommerel B, Wieland T (eds). Amanita Toxins and PoisoningGerhard: Witzstrock Baden-Baden, Verlag, 1980; 155-158
  • Bartels O, Topff G: Amanita phalloides poisoning: Indication for early haemoperfusion. In: Faulstich H, Kommerel B, Wielandeds). Amanita Toxins and Poisoning. Gerhard, Witzstrock Baden- Baden, Verlag, 1980; 147-154
  • Aji DY, Calişkan S, Nayir A, Mat A, Can B, Yaşar Z, Ozşahin HCullu F, Sever L: Haemoperfusion in Amanita phalloides poisoning Trop Pediatr 1995; 41(6): 371-374 Monhart V: Amanita poisoning and the importance of sorption hemoperfusion in its therapy. Vnitr Lek 1997; 43(10): 686-690
  • Eren ŞH, Oğuztürk H, Korkmaz İ, Varol O: The evaluationmushroom poisoning cases recourse to Cumhuriyet University Faculty of Medicine, Emergency Medicine Department in 2004ournal of Cumhuriyet University Faculty of Medicine 2005; 27(1)15-18
  • Oldridge SG, Pegler DN, Spooner BM: Wild mushroom and Toadstool Poisoning, Royal Botanic Gardens, Kew 1989 şıloğlu M, Gücin F, Mat A: Mushroom poisonings occurestanbul, in November 1994. Journal of Ecology & Environmen1995; 14(1): 22-28
  • Öntürk YA, Uçar B: A retrospective study of childhood poisonings n Eskişehir region. Journal of Pediatric Health and Diseases 200346(2): 103-113
  • Akköse AŞ, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O: Adulpoisoning cases between 1996 and 2004. Journal of Uludağ University Faculty of Medicine 2006; 32(1): 25-27
  • Bilir A, Yelken B, Ekemen S, Zeydanoğlu S: Retrospective evaluation of mushroom intoxication cases. Turkiye KlinikleriAnest Reanim 2006;4(3):131-134
APA Kızıltaş Ş, HAKİM DERVİŞ G, Yorulmaz E, KARADAYI ERGİN H, ŞAHİN MANGA G, ALIŞIR ECDER S, Kantarci G (2013). Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. , 45 - 51.
Chicago Kızıltaş Şafak,HAKİM DERVİŞ Gözde,Yorulmaz Elif,KARADAYI ERGİN Hülya,ŞAHİN MANGA Gülizar,ALIŞIR ECDER Sabahat,Kantarci Gulcin Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. (2013): 45 - 51.
MLA Kızıltaş Şafak,HAKİM DERVİŞ Gözde,Yorulmaz Elif,KARADAYI ERGİN Hülya,ŞAHİN MANGA Gülizar,ALIŞIR ECDER Sabahat,Kantarci Gulcin Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. , 2013, ss.45 - 51.
AMA Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. . 2013; 45 - 51.
Vancouver Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. . 2013; 45 - 51.
IEEE Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G "Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases." , ss.45 - 51, 2013.
ISNAD Kızıltaş, Şafak vd. "Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases". (2013), 45-51.
APA Kızıltaş Ş, HAKİM DERVİŞ G, Yorulmaz E, KARADAYI ERGİN H, ŞAHİN MANGA G, ALIŞIR ECDER S, Kantarci G (2013). Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 22(1), 45 - 51.
Chicago Kızıltaş Şafak,HAKİM DERVİŞ Gözde,Yorulmaz Elif,KARADAYI ERGİN Hülya,ŞAHİN MANGA Gülizar,ALIŞIR ECDER Sabahat,Kantarci Gulcin Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 22, no.1 (2013): 45 - 51.
MLA Kızıltaş Şafak,HAKİM DERVİŞ Gözde,Yorulmaz Elif,KARADAYI ERGİN Hülya,ŞAHİN MANGA Gülizar,ALIŞIR ECDER Sabahat,Kantarci Gulcin Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, vol.22, no.1, 2013, ss.45 - 51.
AMA Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2013; 22(1): 45 - 51.
Vancouver Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2013; 22(1): 45 - 51.
IEEE Kızıltaş Ş,HAKİM DERVİŞ G,Yorulmaz E,KARADAYI ERGİN H,ŞAHİN MANGA G,ALIŞIR ECDER S,Kantarci G "Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases." Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 22, ss.45 - 51, 2013.
ISNAD Kızıltaş, Şafak vd. "Clinical, laboratory and prognosis evaluations of our mushroom poisoning cases". Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 22/1 (2013), 45-51.