[Poisoning by green and white mushrooms at a special hepatology unit, 1989-1994]

In the period 1989-1994 eight patients, who were intoxicated with the mushrooms Amanita phalloides (death cap) or Amanita virosa (deadly agaric) were treated at a Department of Hepatology. All patients had had a symptom free period of more than eight hours before the onset of gastrointestinal symptoms; these symptoms lasting in many cases for several days. All patients had biochemical signs of hepatocellular damage and three patients developed hepatic encephalopathy, fulfilling the criteria for fulminant hepatic failure (FHF). Two died and one patient underwent successful urgent liver transplantation. ALL FHF patients had a prothrombin index below 10% and increased creatine. Antidote treatment with penicillin and silibinine should be given promptly on suspicion of Amanita intoxication and should not await biochemical parameters. Transferral to a hepatological department with access to liver transplantation should be considered if abnormal biochemical liver function develops.