Ulcerating Ileocolitis in Severe Amatoxin Poisoning

Table 1

Toxin quantification and inflammatory and organ function parameters at admission with treatment initiation with silibinin and fluimucil and during the initial three days (I + 3 through I + 5), the onset of abdominal symptoms (I + 8), and dismissal from hospital (I + 17). Note the peak of liver injury and dysfunction at I + 4 with rapid recovery and the marked increase in inflammatory parameters at onset of abdominal symptoms.

Days after ingestion	I + 3; hospital admission, treatment initiation	I + 4	I + 5	I + 8; abdominal symptoms	I + 17; dismissal from hospital
Alpha-amanitin (urine) [μg/L]	42.4	2.9	Below threshold (<1.5)	—	—
C-reactive protein [mg/L]	15	24	36	85	5
Lactate [mmol/L]	2.3	2.4	1.1	—	—
Creatinine [μmol/L]	274	94	64	67	83
Blood urea nitrogen [mmol/L]	17.6	14.8	9.6	3.2	1.7
Aspartate-aminotransferase [U/L]	1249	5235	2998	727	30
Alanine-aminotransferase [U/L]	1380	6894	5430	120	19
Factor V [%]	35	Below threshold (<10)	49	121	138
INR [1]	1.6	2.7	1.7	1.2	1.1