Therapeutic plasma exchange in treating multi-organ injury at the later stage of mushroom poisoning: Three case reports
  
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DOI:10.46701/APJBG.20170117018
KeyWord:Mushroom poisoning, Therapeutic plasma exchange, Acute liver injury, Coagulopathy, Hepatic encephalopathy
                                   
AuthorInstitution
Li Chen Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Benxiu Teng Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Juan Luo Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Xianlong Ling Department of Gastroenterology, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Haiyan Zhao Department of Gastroenterology, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Qing Zhang Department of Respiration, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Yuzhu Zeng Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Gaojie Yuan Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Fang Tan Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Yin Ye Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Wenhan Duan Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
Zhongjun Li Department of Blood Transfusion, The Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China.
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Abstract:
      Ingestion of Amanita phalloides, a deadly wild mushroom, can cause multi-organic injury. The value of therapeutic plasma exchange (TPE) in treating mushroom poisoning was controversial, especially for those patients at the later stage. We reported three cases of acute liver injury, coagulopathy, and hepatic encephalopathy secondary to mushroom poisoning at the later stage. Therapeutic plasma exchange (TPE) session was repeated 2~5 times depending on the patients’ conditions. Pathological plasma ranging from 1600 to 1800 mL was exchanged for each session with fresh frozen plasma and normal saline based on the patients’ body weight. Patients’ liver function, coagulation function, and clinical symptoms were immediately improved upon TPE treatment. TPE is a reliable therapy for patients with acute liver injury, coagulopathy, and hepatic encephalopathy secondary to mushroom poisoning at the later stage of poisoning.
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