Gastroenterologie
a hepatologie

Is Amanita phalloides poisoning still a problem?

František Nehaj¹, Juraj Krivuš², Michal Mokáň¹, Marianna Kubašková², Juraj Sokol³, Peter Galajda¹, František Kovář¹, Martin Péč⁴, Marián Mokáň ^{Orcid.org  1}

+ Affiliation
¹ I. interná klinika JLF UK a UN Martin
² Radiologická klinika JLF UK a UN Martin
³ Klinika hematológie a transfuziológie, Národné centrum hemostázy a trombózy JLF UK a UN Martin
⁴ JLF UK v Martine

Summary

Mushroom poisoning is one of the most common acute events. From an epidemiological viewpoint, accidental fungal poisoning occurs frequently in the Slovak Republic, especially during the main growing season of mushrooms in the summer and autumn. Intoxication is divided into several stages with typical symptoms. Several types of syndromes develop according to the type of fungus, the mycotoxins it contains, and the symptoms. These include gastroenterodyspeptic, muscarinic, psilocybin (psychotropic), mycoathropin-neurotoxic, gyromitrin-hepatotoxic, phaloid-hepatorenal, antabus, and orelanin-nephrotoxic syndromes. The fungus should be correctly identified in cases of mushroom poisoning. However, this is not possible in most cases for several reasons. The patient or doctor often lacks sufficient knowledge or theoretical and practical experience of recognizing mushroom species. Clinical pharmacologists and toxicologists can identify mushrooms based on their microscopic and macroscopic characteristics. The type of mushroom is unknown in 95% cases of mushroom poisoning. Amanita phalloides is one of the most poisonous mushrooms and is the cause of the majority of human deaths due to mushroom poisoning worldwide. The liver is the main target organ of toxicity, but other organs, especially the kidneys, are also affected. Intoxication symptoms usually appear after a latent period and may include gastrointestinal disorders followed by jaundice, seizures, and coma, culminating in death. Therapy consists of supportive measures, gastric decontamination, drug therapy, and ultimately liver transplantation if the clinical condition worsens. If necessary, the National Toxic Information Centre in Bratislava or other centers in neighboring countries can be contacted. We present a case report of Amanita phalloides poisoning, diagnostic methods, treatment options, and a review of the literature.

Keywords

amanitin, dyspepsy, hepatic enzymes, Amanita phalloides

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