[Amanitin determination in mushroom poisoning diagnostics].

Area of Science:

• Medical Toxicology
• Clinical Chemistry

Context:

• Annual occurrences of severe mushroom poisonings in Poland necessitate improved diagnostic strategies.
• Effective patient outcomes depend on rapid hospitalization, accurate syndrome differentiation, and timely treatment.

Purpose:

• To evaluate the diagnostic utility of serum and urine amanitin levels and transaminase (ALT, AST) activity in mushroom-poisoned patients.
• To assess these markers up to three days post-ingestion for effective clinical management.

Summary:

• Urine amanitin testing, performed via ELISA, proved highly effective, yielding positive results in all Amanita phalloides syndrome cases within 40 hours of consumption.
• Serum amanitin levels showed limited diagnostic value.
• Transaminase (ALT, AST) activity became a useful differentiator for Amanita phalloides syndrome from the second day onwards, while urine amanitin was key in the initial 24 hours.

Impact:

• Early and accurate diagnosis of mushroom poisoning, particularly Amanita phalloides, can be achieved through timely urine amanitin determination.
• This diagnostic approach facilitates prompt initiation of specific treatments, mitigating the risk of severe internal organ damage and improving patient prognosis.