Elevated serum hyaluronic acid and interleukin-6 levels in patients with mushroom poisoning admitted to the emergency department.

OBJECTIVE To assess the possible use of hyaluronic acid (HA) and interleukin-6 (IL-6) together as a biochemical marker of liver damage in mushroom poisoning (MP). METHODS We prospectively studied patients with MP who were admitted to the emergency service, between April 2005 and April 2007, Samsun, Turkey. Twenty-seven patients with MP were included in the study. Serum HA and IL-6 levels of the patients were determined using enzyme-linked immunosorbent assay daily for a total of 3 days. Ten healthy adults were included in the study to serve as controls. The patients were divided into survivors, and non-survivors. RESULTS There was no significant difference between the patients and controls with respect to serum HA levels on admission (p>0.05). However, IL-6 levels on admission were significantly higher in the patients than the control group (p<0.01). Serum HA and IL-6 levels on admission, and the following days were significantly higher in non-surviving patients (n=5) than in surviving patients (n=22) (p<0.05). There was a significant correlation between HA and IL-6 (r=0.42, p<0.05) on admission. The HA concentration was also significantly correlated with aspartate aminotransferase, alanine aminotransferase, and creatinine levels during the observation period. Serum HA and IL-6 levels increased in non-surviving patients throughout the period of observation. CONCLUSION Increased serum HA and IL-6 levels are associated with hepatic damage in acute MP. Hyaluronic acid may be a useful marker in the assessment of MP-induced acute liver failure in clinical practice.