Four patients with Amanita Phalloides poisoning

Mushroom poisoning by Amanita phalloides is a rare but poten- tially fatal disease. The initial symptoms of nausea, vomiting, ab- dominal pain and diarrhea, which are typical for the intoxication, can be interpreted as a common gastro-enteritis. The intoxication can progress to acute liver and renal failure and eventually death. Recognizing the clinical syndrome is extremely important. In this case report, 4 patients with amatoxin intoxication who showed the typical clinical syndrome are described. The current therapy of amatoxin intoxication is based on small case series, and no ran- domised controlled trials are available. The therapy of amatoxin intoxication consists of supportive care and medical therapy with silibinin and N-acetylcysteine. Patients who develop acute liver fail- ure should be considered for liver transplantation. (Acta gastro- enterol. belg., 2014, 77, 353-356).