Molecular adsorbent recirculating system in dealing with maternal Amanita poisoning during the second pregnancy trimester: a case report

BACKGROUND: A 27-year-old woman in her 20th week of pregnancy was hospitalized because of food poisoning caused by Amanita phalloides. METHODS: Previously extracorporeal purification treat- ments with 2 times of hemodialysis plus hemoperfusion and a high volume therapeutic plasma exchange (PE) in addi- tion to intensive medication during the first 8 days failed to improve hepatic encephalopathy (HE) and liver function but developed deep coma with severe blood chemistry and signs of threatened abortion. RESULTS: Treatments with intermittent molecular adsor- bent recirculating system (MARS) for 3 times resulted in an immediate improvement of liver function and clinical symptoms including HE and threatened abortion until her fully recovery. When the life-threatening maternal illness was cured gestation went on until premature birth at the 36th week of pregnancy, and the infant underwent an un- disturbed development. CONCLUSION: MARS method appears to be an optimal therapy for patients with acute liver failure secondary to cy- toxic mushroom poisoning during pregnancy.