Mantar zehirlenmesine bağlı rabdomiyoliz zemininde ağır böbrek, karaciğer ve kalp hasarı

Sema Taban; Belda Dursun

doi:10.17826/cumj.531730

Olgu Sunumu

Severe acute renal, hepatic and cardiac failure in the setting of rhabdomyolysis due to mushroom poisoning

Yıl 2019, Cilt: 44 Sayı: 4, 1515 - 1519, 29.12.2019

Sema Taban Belda Dursun

https://doi.org/10.17826/cumj.531730

Öz

Amanita species are the most common cause of mushroom poisoning with a high rate of mortality. A 58 years old woman who had a mushroom intake history 3 days ago was presented with nausea, vomiting and decrease in urine volume. The patient was evaluated to have acute kidney, liver and cardiac injury in the setting of rhabdomyolysis due to mushroom poisoning. Besides medical support therapy she received hemodialysis and plasmapheresis treatments, which resulted in complete clinical and laboratory improvement. We emphasized the significance of mushroom poisoning in the context of their wide clinical presentation spectrum and potentially lethal feature.

Anahtar Kelimeler

Mushroom poisoning, acute kidney injury, rhabdomyolysis, cardiac injury

Kaynakça

1) Eren Ş H. 2004 yılı içerisinde Cumhuriyet Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı’na başvuran mantar zehirlenmesi vakalarının değerlendirilmesi. Cumhuriyet Üniversitesi Tıp Fakültesi Dergisi.2005; 27(1):15-18.
2) T.C. Sağlık Bakanlığı Birinci Basamağa Yönelik Zehirlenmeler Tanı ve Tedavi Rehberleri 2007. Mantar Zehirlenmesi. Sayfa:137-42. 3) Eren SH. Mushroom poisoning: retrospective analysis of 294 cases. Clinics (Sao Paulo) 2010;65:491-6.
4) Kalkan Ş, Tunçok Y, Güven H. İlaç ve Zehir Danışma Merkezine bildirilen olgular. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi 1998;12:275-83.
5) Lionte CC, Sorodoc LL, Simionescu VV. Successful treatment of an adult with Amanita phalloides-induced fulminant liver failure with molecular adsorbent recirculating system (MARS). Rom J Gastroenterol 2005;14:267-71.
6) Powerance HH, Bauness ES, Kohli-Kumar M et al, A 15 year-old boy with fulminant hepatic failure. J Pediatr 2000;137:114-8.
7) Faulstich H: New aspects of Amanita poisoning. Klin Nochenschr 1979;57:143-52.
8) Evrenkaya TR, Atasoyu EM. Mantar zehirlenmelerinde ekstra korporal tedaviler. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 2001;10:14-8.
9) Leathem AM, Pursell RA, Chan VR, Kroeger PD. Renal failure caused by mushroom poisoning. J Toxicol Clin Toxicol. 1997;35:67. 10) Boutaud O, Roberts LJ. Mechanism based therapeutic approaches to rhabdomyolysis induced renal failure. Free Radic Biol Med. 2011;51:1062-7.
11) Bagley WH, Yang H, Shah KH. Rhabdomyolysis. Intern Emerg Med. 2007;2:210-8.
12) Punkollu G, Gowda RM, Khan IA, Mehta NJ, Navarro V, Vasavda BC. Elevated serum cardiac troponin I in rhabdomyolysis. International Journal of Cardiology 2004;96:35-40.
13) Unverir P, Soner BC, Dedeoğlu E, Karcioğlu O, Boztok K, Tuncok Y. Renal and hepatic injury with elevated cardiac enzymes in Amanita phalloides poisoning: a case report. Hum Exp Toxicol. 2007;26(9):757-61.
14) Aygul N, Duzenli MA, Ozdemir K, Altunkeser BB. A case report of an unusual complication of Amanita phalloides poisoning: Development of cardiogenic shock and its successful treatment with intra-aortic balloon counterpulsation. Toxicon. 2010;55(2-3):630-2.
15) Besancon A, Scmitt C, Glaizal M, et al. Occurence of severe cardiac alterations in Amanita proxima poisoning: two original observations. Ann Fr Anesth Reanim.2012;31(5):466-8.
16) West PL, Lindgren J, Horowitz BZ. Amanita smithiana mushroom ingestion: a case of delayed renal failure and literature review. J Med Toxicol. 2009;5:32.
17) Jander S, Bischoff J, Woodcock BG: Plasmapheresis in the treatment of amanita phalloides poisoning: A rewiev and recommendations. Ther Apher 2000;4:308-12.