Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Juliana Garcia (Author) Other; Vera M Costa (Author) Other; Ana Elisa Costa (Author) Other; Sergio Andrade (Author) Other; Ana Cristina Carneiro (Author) Other; Filipe Conceicao (Author) Other; Jose Artur Paiva (Author) Other; de Pinho, PG (Author) FFUP; Paula Baptista (Author) Other; Maria de Lourdes Bastos (Author) FFUP; Felix Carvalho (Author) FFUP

Journal

Title: Toxicon

Vol. 103

Pages: 55-59

ISSN: 0041-0101

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 9 Citations

Scopus - 15 Citations

Scientific classification

FOS: Medical and Health sciences > Basic medicine

Other information

Authenticus ID: P-00G-CN4

DOI: 10.1016/j.toxicon.2015.06.012

Abstract (EN): Mushroom poisonings occur when ingestion of wild mushrooms containing toxins takes place, placing the consumers at life-threatening risk. In the present case report, an unusual multiple poisoning with isoxazoles- and amatoxins-containing mushrooms in a context of altered mental state and poorly controlled hypertension is presented. A 68-year-old female was presented to Sao Joao hospital (Portugal) with complaints of extreme dizziness, hallucinations, vertigo and imbalance, 3 h after consuming a stew of wild mushrooms. The first observations revealed altered mental state and elevated blood pressure. The examination of cooked mushroom fragments allowed a preliminary identification of Amanita pantherina. Gas chromatography-mass spectrometry (GC-MS) showed the presence of muscimol in urine. Moreover, through high-performance liquid chromatography-ultraviolet detection (HPLC-UV) analysis of the gastric juice, the presence of alpha-amanitin was found, showing that amatoxins-containing mushrooms were also included in the stew. After 4 days of supportive treatment, activated charcoal, silybin and N-acetylcysteine, the patient recovered being discharged 10 days post-ingestion with no organ complications. The prompt and appropriate therapy protocol for life-threatening amatoxins toxicity probably saved the patient's life as oral absorption was decreased and also supportive care was immediately started.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5