muscaria mushroom consumed by the patient in this report did not contain amatoxin
, the event underscored that mushroom intoxications continue to be a concern for newly arrived persons accustomed to foraging in their home countries, who might not be familiar with local mushroom ecology.
Legalon(R) SIL: the antidote of choice in patients with acute hepatotoxicity from amatoxin
Ganzert et al  retrospectively analysed the outcome of a large series of amatoxin intoxication cases and found that predictors of death were the prothrombin time in combination with the serum creatinine level on 3-10 days after ingestion.
Ganzert et al  retrospectively analysed the outcome of a large series of amatoxin intoxication cases and found that predictors of death were the prothrombin index in combination with the serum creatinine level on 3-10 days after ingestion.
Indication of liver transplantation following amatoxin intoxication.
Administration of cimetidine, a cytochrome P-450 inhibitor which inhibits the uptake of amatoxins
by the mixed function oxidase system, and N-acetylcysteine (NAC), a glutathione precursor that binds amatoxin-related free radicals, have also been used in the treatment of amanitin intoxication.
Legalon[R] SIL: the antidote of choice in patients with acute hepatotoxicity from amatoxin poisoning.
([dagger]) Silibinin dihemisuccinate, a milk thistle extract, competitively inhibits hepatic amatoxin uptake and enterohepatic recycling, and is available in the United States through an open clinical trial.
Amatoxins, consisting of alpha, beta, and gamma amanitin, account for >90% of deaths related to mushroom poisoning worldwide (1).
No correlation exists between the plasma amatoxin concentration and clinical outcome, nor does the amount of liver-bound toxin correlate with the plasma concentration.
Silymarine (from the milk thistle Silibum marianum) exerts its protective effect after intravenous administration in various ways: (a) by interrupting the enterohepatic recirculation of amanitin; (b) by inhibiting the binding of toxins to hepatocyte membranes; (c) by competing with amatoxin for transmembrane transport; and (d) by inhibiting the penetration of amanitin into liver cells (1).
Amatoxins, which constitute the second group of Amanita toxins, are cyclic octapeptides that interfere with DNA transcription (3).