Case Study : Acute Liver Failure From Fungal Toxins

1392 WordsDec 23, 20156 Pages
Case study: Acute liver failure from fungal toxins. INTRODUCTION A 20-year old male presented to the hospital with: nausea; diarrhoea and fever. Upon examination he had abdominal pain and a tender liver. The patient admitted to eating wild mushrooms, of which he had collected himself, the afternoon before attending the hospital. Laboratory analysis at the time of admission revealed elevated serum ALT (665 U/L) and AST (880 U/L), increased total bilirubin (4.9mg/dL) and an increased prothrombin time (3.11 seconds). Laboratory tests were repeated six hours later and all levels, except AST, were elevated even further; with ALT and bilirubin doubling in concentration and the prothrombin time also doubling. Albumin concentration was also tested and presented normal at both times. The patient was administered a haemodialysis with N-acetylcysteine. SYMPTOMS & DIAGNOSIS The 20-year old male was experiencing nausea and diarrhoea; a common result of mushroom poisoning due to the gastrointestinal irritants contained within the mushrooms. However, considering these symptoms alongside the abdominal pain and tender liver, suggested inflammation of the liver, problems with liver function and hence suspected acute hepatitis or liver failure. Biochemical tests were performed to test the function of the liver and the results were as shown in Table 1. These tests were used to estimate the severity of the disease and hence the likelihood of the continuation into acute liver failure. Table

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