Acute Pancreatitis Caused By Mushroom Poisoning: A Report of Two Cases

Biodistribution of radiolabeled alpha-amanitin in mice: An Investigation

Mushroom poisonings caused by Amanita phalloides are the leading cause of mushroom-related deaths worldwide. Alpha-Amanitin (α-AMA), a toxic substance present in these mushrooms, is responsible for the resulting hepatotoxicity and nephrotoxicity. The objective of our study was to determine the distribution of α-AMA in Balb/c mice by labeling with Iodine-131. Mice were injected with a toxic dose (1.4 mg/kg) of α-AMA labeled with Iodine-131. The mice were sacrificed at the 1st, 2nd, 4th, 8th, 24th, and 48th hours under anesthesia. The organs of the mice were removed, and their biodistribution was assessed in all experiments. The percent injected dose per gram (ID/g %) value for kidney, liver, lung, and heart tissues at 1st hour were 1.59 ± 0.07, 1.25 ± 0.33, 3.67 ± 0.80 and 1.07 ± 0.01 respectively. This study provides insights into the potential long-term effects of α-AMA accumulation in specific organs. Additionally, this study has generated essential data that can be used to demonstrate the impact of antidotes on the biological distribution of α-AMA in future toxicity models.

Demographic, clinical, and laboratory findings of mushroom-poisoned patients in Kermanshah province, west of Iran

Background

Mushroom poisoning can cause gastrointestinal, renal, and hepatic symptoms and even death. This descriptive study examined the demographic, clinical, and laboratory findings of patients with fungal poisoning, a type of fungus causing the poisoning, and the incidence and mortality rates of fungal poisoning in Kermanshah province, western Iran, from 2014 to 2018.

Methods

The medical records of 193 patients with mushroom poisoning from 2014 to 2018 were evaluated. The liver and kidney function tests, electrolytes, abdominal and pelvic ultrasound, chest x-ray, coagulation tests, and coagulation factors (fibrinogen, prothrombin) were assessed. Data were collected from the medical records of patients admitted to the Poisoning Center of Imam Khomeini Hospital in Kermanshah, Iran using a researcher-made checklist. Data were analyzed by SPSS (version 16) using descriptive statistics, including mean, standard deviation, and frequency distribution tables. Trend analysis for proportion was done by chi-square statistics in STATA-14 software (ptrend command).

Results

Of cases, ‌51.3% were male, 92.6% were city dwellers, 38.3% were aged 21–40 years, and 92.5% were poisoned during the spring. The fungus that caused poisoning was Amanita virosa. The gastrointestinal, nervous, and visual systems were the most common systems involved. The most common gastrointestinal symptoms included nausea and vomiting (72.0%) and abdominal pain (71.0%). Vertigo (11.9%) and headache (9.3%) were the most common neurological symptoms. The most common visual manifestation was blurred vision (7.8%). Of cases, 23.7% had metabolic acidosis. The increased alkaline phosphatase level was the most common liver disorder in 98.7% of the cases. Increased blood urea nitrogen and creatinine levels were also reported in 21.0% and 17.7% of the cases, respectively. The serum lactic dehydrogenase and creatine phosphokinase levels also increased in 99.3% and 30.2% of the patients, respectively. The mortality rate was 1.6% (n = 3).

Conclusion

The fungal poisoning diagnosis should always be considered in young patients referred to the emergency department with gastrointestinal complaints, a history of consuming wild self-picked mushrooms, and high liver and kidney test values. Since most fungal poisonings occur in the spring, it is necessary to inform the community of the dangers of consuming self-picked wild mushrooms, especially in this season.

Epidemiological analysis of wild mushroom poisoning in Zhejiang province, China, 2016-2018

Wild mushroom poisoning has been recognized as a global problem threatening human health. In this study, we aimed to explore characteristics of wild mushroom poisoning in Zhejiang province, China. From 2016 to 2018, 429 cases of wild mushroom poisoning were reported, and among them, there were 2 deaths and 84 hospitalizations, with the incidence of 0.2526 per 100,000 and the case fatality rate of 0.47%. Digestive symptoms were found in all cases. Systemic symptoms and signs, neurological symptoms, and urinary symptoms were found in 28.90% (124/429), 11.66% (50/429), and 4.90% (21/429) of the cases, respectively. The proportion of cases with incubation period <6 h was 85.78%, and those with ≥6 h accounted for 14.22%. The peak period of poisoning occurred from June to October annually. Quzhou (Moran's I = 1.242, p < .05) and Lishui (Moran's I = 0.759, p < .05) with mild climate, more mountains, and abundant rainfall were "hot spots" for the incidence of wild mushroom poisoning, showing a state of high-incidence aggregation. Epidemiological analysis showed that there were seasonal, high-incidence areas and high-risk groups in wild mushroom poisoning. The government should give early warning to high-incidence areas and strengthen publicity to high-risk groups before wild mushrooms mature every summer and autumn. In addition, we recommend that ordinary people not pick wild mushrooms outdoors for consumption, because it is difficult to distinguish whether wild mushrooms are poisonous and do not buy wild mushrooms of unknown sources.