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[Phallin syndrome. Reports on 28 cases].

L Ghiringhelli, A Ceriani, G Lepore

    Minerva Medica
    |September 29, 1981
    PubMed
    Summary

    Amanita mushroom poisoning, or phallinic syndrome, causes severe gastrointestinal, liver, and kidney issues. Early and aggressive treatments like peritoneal dialysis or forced diuresis are crucial for survival, significantly improving outcomes compared to supportive care alone.

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    Area of Science:

    • Toxicology
    • Internal Medicine
    • Gastroenterology

    Context:

    • Phallinic syndrome results from Amanita mushroom poisoning, specifically Amanita phalloides and Amanita verna.
    • Initial symptoms include a lag phase followed by severe gastrointestinal distress, hepatic, and renal involvement.
    • Laboratory findings reveal elevated liver enzymes, hyperbilirubinemia, elevated BUN, and decreased clotting factors in severe cases.

    Purpose:

    • To analyze the clinical presentation and outcomes of phallinic syndrome.
    • To evaluate the efficacy of various therapeutic interventions for Amanita mushroom poisoning.
    • To emphasize the importance of prompt and aggressive medical treatment.

    Summary:

    • A study of 28 cases (24 Amanita phalloides, 4 Amanita verna) revealed a 7-30 hour lag phase before gastrointestinal symptoms, progressing to hepatic and renal damage.
    • Supportive care alone had limited success, with 3 deaths. Peritoneal dialysis (with or without exchange transfusion) and forced diuresis showed excellent outcomes, with no deaths in treated patients.
    • Aggressive interventions like peritoneal dialysis and forced diuresis are vital to reduce toxin levels and prevent systemic diffusion, improving patient survival rates.

    Impact:

    • Highlights the critical role of early and aggressive interventions in managing severe Amanita mushroom poisoning.
    • Demonstrates the superior efficacy of procedures like peritoneal dialysis and forced diuresis over supportive care alone.
    • Provides crucial insights for medical professionals on effective treatment strategies for phallinic syndrome, aiming to reduce mortality and improve recovery.

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