Georgetown University Medical Center Teams Up to Offer Investigational Drug as Alternative to Liver Transplant

(Washington, DC) – Physicians at Georgetown University Hospital say two local men are lucky to be alive after eating and becoming very ill from the deadly Amanita mushrooms. The men ate the mushrooms that were growing in or near their homes in two separate incidents about a week apart.

While Death Cap and Destroying Angel mushrooms can often resemble some edible mushrooms, these fungi are highly toxic if ingested.

It all started back on September 12 when 49 year-old Frank Constantinopla of Springfield, Virginia saw the mushrooms growing in his backyard. Thinking they were safe to eat, he cooked them up in a stir fry that he and his wife had for breakfast. “Within two hours I was very, very ill,” said Mr. Constantinopla. He suffered severe nausea, vomiting and diarrhea. On Wednesday of that week, Mr. Constantinopla went to the emergency room near his home. By then he was in the early stages of liver failure. Thursday morning he was transferred to Georgetown University Hospital because of the possible need for a liver transplant.

“Mr. Constantinopla was transferred here to Georgetown University Hospital and we made a clinical diagnosis of mushroom poisoning,” said Jacqueline Laurin, MD, a liver transplant specialist at Georgetown University Hospital. “He had eaten the mushrooms, gotten very ill with gastrointestinal symptoms and his liver enzymes were extremely high, meaning the mushroom toxin was poisoning his liver. Often in these cases, patients end up needing a liver transplant or the poisoning can end in death.”

Physicians at Georgetown called in a mycologist (a mushroom expert) who took a look at the mushrooms and suspects Mr. Constantinopla ate the Amanita phalloides, also known as “Death Cap.”

Georgetown physicians contacted the local Poison Control Center who put them in contact with a physician in California whose IV preparation of milk thistle, (Silibinin sold under the name Legalon) and made in Germany, had approval for clinical investigation in the United States. Arrangements were made to get the drug flown and couriered to Georgetown University Hospital from Pennsylvania. Because the drug is still investigational, physicians at GUH could only give it once as an “emergency use.” Mr. Constantinopla received the drug that Thursday evening September 15.

Georgetown Transplant Institute (GTI), whose research is conducted by Georgetown University Medical Center, began preparing an IRB application so there would be an approved protocol open in case another patient would need it. On Wednesday, a second patient, 82 year-old Walter Lantz Jr of Frederick, Maryland was transferred to Georgetown with suspected mushroom poisoning.

That prompted an emergency meeting of the Institutional Review Board comprised of clinical and non-clinical people from Georgetown University Medical Center and Georgetown University Hospital, who approved the protocol, thus allowing the second patient to be treated with the same IV preparation of milk thistle.

“We think Mr. Lantz ate Amanita bisporigera, another type of deadly mushroom, “ said Dr. Laurin.

“I’ve eaten mushrooms around my property for years,” said Mr. Lantz, a retired farmer. “I guess I’d never eaten that type before. I was so sick. It was terrible. But they saved my life here, for sure.”

“These gentlemen were very lucky. Because of this now approved protocol, if there are any cases of mushroom poisoning in the future, GUH is an approved referral center for this IV preparation of milk thistle,” said Dr. Laurin. “We hope the public will get the message though. Our area has seen a lot of rain and dampness in the past month meaning there are a lot of mushrooms sprouting up in people’s yards. We hope people will leave those alone.”

Media Contact: Marianne Worley
Phone: 703-558-1287
Email: WorleyM@gunet.georgetown.edu

Patient Contact: 202-342-2400