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Clinical Chemistry 47: 971-974, 2001;
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(Clinical Chemistry. 2001;47:971-974.)
© 2001 American Association for Clinical Chemistry, Inc.

Articles

Management of Maternal Amanita phalloïdes Poisoning during the First Trimester of Pregnancy: A Case Report and Review of the Literature

Jean-Christophe Boyer1a, Francois Hernandez2, Jacques Estorc2, Jean-Emmanuel De La Coussaye2 and Jean-Pierre Bali1

Centre Hospitalier Universitaire de Nîmes,
1 Service de Biochimie and
2 Département de l’Urgence, Urgences Medico-Chirurgicale d’Hospitalisation, 5 Rue Hoche, 30006 Nîmes, France.

aAuthor for correspondence. Fax 33-4-6668-3205; e-mail jean.christophe.boyer{at}chu-nimes.fr.

Background: Amanita phalloïdes poisoning produces acute liver failure and often death. Maternal poisonings are rare, and medical decisions of abortion or liver transplantation in this critical situation frequently are based on laboratory data. We report here the case of a 22-year-old-woman in the 11th week of pregnancy, who ingested mushrooms.

Case Report: The patient’s clinical symptoms (e.g., vomiting and diarrhea) and blood chemistry data (persistent increases of aspartate aminotransferase and alanine aminotransferase and severe decreases in prothrombin, factor V, factor II, factor VII, and factor X) indicated poisoning of medium severity. The management consisted of intravenous hydration, and administration of silymarine and N-acetylcysteine. No fetal damage was observed, and birth and development of the infant (now 2 years of age) proceeded without incident.

Conclusion: Abortion is not necessarily indicated in maternal poisoning by A. phalloïdes, even in the first trimester of pregnancy.




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