Çocuklarda mantar zehirlenmesi:26 olgunun değerlendirilmesi
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Tarih
2012
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Amanita phalloides (A phalloides) türü ile olan mantar zehirlenmeleri en tehlikeli mantar zehirlenmeleri olup, ölüme yol açabilmektedir. Fakat, A. Phalloides zehirlenmeleri erken tanı ve etkin tedavi ile kurtarılabilir. Biz uygun veri kaynaklarını kullanarak Ankara’daki mantar zehirlenmelerini araştırdık. Materyal ve Metot: Bu çalışma, Ocak 1998’den Haziran 2001’e kadar Dr. Sami Ulus Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesinde yatan hasta ve acil servis verilerinden rapor edilen mantar zehirlenmesi olan 26 hastada yapılmıştır. Bulgular: Hastaların yaş dağılımları 2-16 (ortalama 10) yaş arasında değişiyordu. Önemli belirtiler kusma, bulantı, karın ağrısı ve ishal gibi gastrointestinal sistemle ilgiliydi. En sık saptanan patolojik laboratuvar testleri: 6 (%23) hastada karaciğer enzimleri yüksek, 4 (%15,3) hastada protrombin/aktive parsiyel tromboplastin zamanı uzamış ve 3 (%11,5) hastanın böbrek fonksiyon testleri bozulmuştu. Hastaneye başvurudan sonraki ilk 36 saat içinde hastalara mide yıkama, aktif kömür, damar içine sıvı ve penisilin G infüzyonu uygulandı. Spesifik amatoksin antidotu olan silibinin 2001 yılında hastaneye başvuran 10 (%38,4) hastaya verildi. Fulminan hepatik yetmezlik gelişen 2 ve hepatorenal yetmezlik gelişen 1 hastaya ileri tedavi olarak plazmaferez ve hemodiyaliz uygulandı. Hastaların 22 (%84,3) tam iyileşmiş olarak taburcu edildi. Dört hasta (%15,7) ise komplikasyonlara bağlı olarak hastanede öldü. Sonuç: Halk yabani mantar alımıyla oluşabilecek tehlikeler hakkında bilgilendirilmelidir. Toksikoloji merkezlerinde vücut sıvılarından etken mantar türü saptanmalı ve ciddi mantar zehirlenmesi olan hastalara etkin antidot verilmelidir, ancak Türkiye koşullarında bu mümkün değildir.
Objective: Exposure to Amanita phalloides is the most dangerous mushroom poisoning and can lead to death. However, early diagnosis and effective treatment can be recovered the poisoning with A. phalloides. We described mushroom poisonings in Ankara using available data sources. Material and Methods: We performed the study of 26 patients with mushroom poisoning reported in Dr. Sami Ulus Children’s Health and Diseases Training and Research Hospital inpatient and emergency department data from January 1998 through June 2001. Results: The patients' age ranged between 2 and 16 years, with a median of 10 years of age. Major symptoms were related with the gastrointestinal system such as vomiting, nausea, abdominal pain, and diarrhea. The most frequently reported pathological laboratory tests were increased liver enzymes (23%), prolonged prothrombin/activated partial thromboplastin time (15.3%), and impaired renal functions (11.5%) in the patients. In the first 36 hours after admission to the hospital, the patients were managed with gastric lavage, activated charcoal, intravenous fluid, and penicillin Ginfusion. Silibinin, a specific antidote of amatoksin, was given to 10 patients (38.4%) admitted to the hospital in 2001. Plasmapheresis and hemodialysis were administered as further treatment to the patients who developed fulminant hepatic failure in two and acute hepatorenal failure in one. Twenty-two (84.3%) of the patients were discharged with recovery. Four patients (15.7%) died in the hospital due to complications. Conclusions: The public should be informed about the probable hazards of wild mushroom ingestion. The species of active fungus should be detected in body fluids by the toxicology center and active antidote is given to not possible in throughout Turkey in actuel conditions.
Objective: Exposure to Amanita phalloides is the most dangerous mushroom poisoning and can lead to death. However, early diagnosis and effective treatment can be recovered the poisoning with A. phalloides. We described mushroom poisonings in Ankara using available data sources. Material and Methods: We performed the study of 26 patients with mushroom poisoning reported in Dr. Sami Ulus Children’s Health and Diseases Training and Research Hospital inpatient and emergency department data from January 1998 through June 2001. Results: The patients' age ranged between 2 and 16 years, with a median of 10 years of age. Major symptoms were related with the gastrointestinal system such as vomiting, nausea, abdominal pain, and diarrhea. The most frequently reported pathological laboratory tests were increased liver enzymes (23%), prolonged prothrombin/activated partial thromboplastin time (15.3%), and impaired renal functions (11.5%) in the patients. In the first 36 hours after admission to the hospital, the patients were managed with gastric lavage, activated charcoal, intravenous fluid, and penicillin Ginfusion. Silibinin, a specific antidote of amatoksin, was given to 10 patients (38.4%) admitted to the hospital in 2001. Plasmapheresis and hemodialysis were administered as further treatment to the patients who developed fulminant hepatic failure in two and acute hepatorenal failure in one. Twenty-two (84.3%) of the patients were discharged with recovery. Four patients (15.7%) died in the hospital due to complications. Conclusions: The public should be informed about the probable hazards of wild mushroom ingestion. The species of active fungus should be detected in body fluids by the toxicology center and active antidote is given to not possible in throughout Turkey in actuel conditions.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Yeni Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
29
Sayı
3
Künye
Köksal T., Demirçeken F. G., Köksal A. O., Arslan Z. (2012). Çocuklarda mantar zehirlenmesi:26 olgunun değerlendirilmesi. Yeni Tıp Dergisi, 29(3), 155 - 157.