Usefulness of 13C-methacetin breath test in liver function testing in Amanita phalloides poisoning; breast feeding woman case

Figures & data

Table 1.  Laboratory data: days II–V after Amanita phalloides ingestion

Day	AST (U/L)	ALT (U/L)	Total bilirubin (μmol/L)	INR	Prothrombin activity (%)	Prothrombin time (s)	APTT (s)	Ammonia (μmol/L)	Blood urea nitrogen (μmol/L)	Creatinine (μmol/L)	Lactic acid (mmol/L)	Glucose (mmol/L)	EN degree
II	32	25	2.9	4.65	23
III	7,000	4,526	32.4	4.65	23					70			I
		11,040	6,005	64.5	8.96	11.6
IV Liver dialysis	10,533	5,842	61.6	8.96	11.6	47.4	70.5	94.5			7.7	1.97	II
			56.3	3.62	26.6	76.4	57	47				5.62
	5,806	3,444	38.1	6.28	16.5		Not clotting	26.3	0.2	54		4.37	I
				5.3	19.5
				6.47	16
V Liver dialysis	4,196	3,106	59.1	0	0		87.5	152.6			7.2	4.9	III/IV
												4.8
	2,494	1,979	37.6	4.67	22	22	Not clotting	70.5	<11	51	3.1	8.3	III
											1.2
											7.2
VI						Liver transplantation

AST (U/L) n: <42; total bilirubin (μmol/L) n: <17; INR (prothrombin international normalized ratio) n: 0.8–1.3; prothrombin activity n: 80.0–120; pTT (activated partial thrombin time) n: 24.0–36.0; prothrombin time n: 9.5–15.7; ammonia (mmol/L) n: 11–47; blood urea nitrogen (mmol/L) n: 2.5–6.5; creatinine (μmol/L) n: 53–115; lactic acid (mmol/L) n: 0.5–2.2; glucose (mmol/L) n: 3.3–5.6; EN – encephalopathy degree (West Haven criteria).

Table 2.  Cumulative percent 13C-dose recovery in control group and in the reported case (GR)

	%13C cumulative dose
Time	Controls (mean)	GR 4.10.06	GR 5.10.06
0	0	0.00	0.00
10	0.73	0.02	0.00
20	3.14	0.05	0.00
30	6.72	0.07	0.02
40	10.48	0.09	0.02
50	13.93	0.11	0.01
60	16.90	0.12	0.06

Fig. 1.  Results of 13C-MBT in the patient (GR) presented as cumulative percentage of administrated dose of 13C recovered over time on the fourth and fifth day (linear regression analysis data).