Factors Associated with Acute Liver Injury from Wild Mushroom Ingestion, Kapchoeng Hospital, Surin

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Sirinrat Sangsirilak Akekalak Sangsirilak

Abstract

Background: Acute liver injury (ALI) from mushroom poisoning patient has been increased in each year in Kapchoeng hospital.
Aims: To identify the associated factors with ALI in mushroom poisoning patient in Kapchoeng district, Surin province.
Methods: This retrospective cohort study review records and electronic charts involved with All patients were admitted with diagnosis of mushroom poisoning by ICD-10 code T60.2 from 1st January 2013 to 30th September 2017. Who had the onset of gastrointestinal symptoms, such as watery diarrhea, vomiting, and/or abdominal pain after mushroom ingestion. We excluded the other possible causes of acute liver injury and cannot find the record or electronic chart. Acute liver injury was defined by serum ASTrising over 400 IU/L. Personals, laboratory, environment and treatment factor were collected by review from records and database. Data analysis was performed using descriptive statistics and the factors associated with ALI in mushroom poisoning patients were identified by multiple logistic regression analysis with backward elimination method and the association were presented as adjusted RR and 95%CI at level of significant < 0.05.
Results: The results showed in 128 patients, 59.4% were women, the age average was 50.5 years old. Comorbid diseases were diabetes mellitus (7.8%), hypertension (7.8%),and alcohol drinking(17.2%). The onset of gastrointestinal symptoms over 6 hours were 24.4%. the time from ingest to door over 6 hours were 50.8%. Patients were admitted maximum in July of every year. The results showed 17 patients with acute liver injury from eating toxic mushroom. Male patients had more risk 2.7 times than females(RR=2.7: 95%CI =1.1-6.8).
Keywords: mushroom poisoning, mushroom ingestion, food poisoning, toxic mushroom, acute liver injury

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References

1. อิฏฐผล เอี้ยววงษ์เจริญ, แนวทางการรักษาผู้ป่วยที่ได้รับพิษจากเห็ด (Mycetism). [อินเตอร์เน็ท]. 2560. [สืบค้นเมื่อวันที่ 10 มิ.ย. 2560]. เข้าถึงได้จาก: URL: https://wwwnno.moph.go.th/epidnan/downloads/handbooks/Mycetism-guideline-2557.pdf

2. สำนักระบาดวิทยา กรมควบคุมโรค กระทรวงสาธารณสุข. รายงานการเฝ้าระวังทางระบาดวิทยาประจำสัปดาห์. สถานการณ์โรคอาหารเป็นพิษจากเห็ด ประเทศไทย 2559:47;22:10 มิถุนายน 2559.

3. ศูนย์พิษวิทยา สถาบันวิจัยวิทยาศาสตร์สาธารณสุข. เห็ดพิษที่พบบ่อยในประเทศไทย. [อินเตอร์เน็ท]. 2560. [สืบค้นเมื่อวันที่ 10 มิ.ย. 2560]. เข้าถึงได้จาก:URL: https://nih.dmsc.moph.go.th/data/data/fact_sheet/6_60.pdf

4. Bonacini M, Shetler K, Yu I, Osorio RC, Osorio RW. Features of Patients With Severe Hepatitis Due to Mushroom Poisoning and Factors Associated With Outcome. Clin Gastroenterol Hepatol 2017;15(5):776-9.

5. Kim T, Lee D, Lee JH, Lee YS, Oh BJ, Lim KS, Kim WY. Predictors of poor outcomes in patients with wild mushroom-induced acute liver injury. World J Gastroenterol 2017;23(7):1262-7.

6. Eren SH, Demirel Y, Ugurlu S, Korkmaz I, Aktas C, Güven FM. Mushroom poisoning: retrospective analysis of 294 cases. Clinics (Sao Paulo. 2010;65(5):491-6.

7. Santi L, Maggioli C, Mastroroberto M, Tufoni M, Napoli L, Caraceni P. Acute Liver Failure Caused by Amanita phalloides Poisoning. Int J Hepatol 2012;2012:487480.

8. Chan CK, Lam HC, Chiu SW, Tse ML, Lau FL. Mushroom poisoning in Hong Kong: a ten-year review. Hong Kong Med J 2016;22(2):124-30.

9. Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Yealy DM, Meckler GD. Tintinalli’s emergency medicine : a comprehensive study guide. 8th.ed. New York : McGraw-Hill, 2015.