Laura Smith
Mushroom poisoning is a significant health risk, particularly in rural areas, and can lead to liver failure and even death. While most ingested mushrooms are nontoxic or cause only mild gastrointestinal irritation, certain species, such as those from the Amanita genus, contain amatoxins, which have severe hepatotoxic effects. Amatoxin poisoning is a worldwide problem, causing approximately 50–100 fatal cases in Western Europe each year. The challenge lies in the accurate identification of mushroom species, as definitive methods are lacking, and symptoms may take several hours to manifest. Therefore, prevention through minimizing exposure to potentially toxic mushrooms and seeking immediate medical attention in suspected cases of poisoning are crucial.
| Characteristics | Values |
|---|---|
| Types of mushrooms worldwide | Over 5,000 |
| Types of toxic mushrooms | 100 out of 1,500-2,000 |
| Amatoxin poisoning cases per year in Western Europe | 50-100 |
| Amatoxin poisoning cases per year in the United States | Less common |
| Amatoxin poisoning cases in Africa, Asia, Australia, Central and South America | Present |
| Percentage of poisonous mushrooms | 3% |
| Amatoxin poisoning symptoms | Nausea, vomiting, abdominal pain, diarrhea, syncope, hallucinations |
| Amatoxin poisoning treatment | Induction of vomiting, gastric lavage, administration of activated charcoal, IV fluids, anti-nausea medications, antacids, anti-diarrheal medications, liver supplements |
| Types of mushroom toxins with fatal courses of intoxication | Amatoxin-containing Amanita group, Phallotoxin |
| Percentage of mushroom-induced poisoning that is due to the Amanita group | 90% |
| Mushroom poisoning symptoms | Nausea, vomiting, abdominal pain, diarrhea |
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What You'll Learn
- Amanita phalloides, the 'death cap mushroom', is an amatoxin-containing mushroom that causes liver failure
- Amatoxins inhibit the RNA polymerase enzyme, impairing the liver's regenerative capacity
- Mushroom poisoning symptoms include nausea, vomiting, abdominal pain, and hallucinations
- Treatment for mushroom poisoning includes decontamination, IV fluids, and liver supplements
- Mushroom identification is difficult, even for experts, and there is no simple test for toxicity
Amanita phalloides, the 'death cap mushroom', is an amatoxin-containing mushroom that causes liver failure
Mushrooms are generally not hepatotoxic, but some species are poisonous and can cause liver failure. Amatoxin-containing mushrooms are a rare but significant cause of acute fulminant liver failure. Amatoxins are rapidly absorbed from the intestine and transported into the liver, where they inhibit RNA polymerase, disrupting mRNA transcription and causing protein deficit and, ultimately, cell death.
Amanita phalloides, also known as the death cap mushroom, is an amatoxin-containing mushroom that causes liver failure. It is the most poisonous of all known mushrooms and is responsible for the majority of human fatal cases of mushroom poisoning worldwide. It is estimated that as little as half a mushroom contains enough toxin to kill an adult human.
The principal toxic constituent of Amanita phalloides is α-amanitin, which is the main component responsible for its toxic effects. The mushroom also contains β-amanitin, phallotoxins, and virotoxins, which are minor active peptides. Amanita phalloides resembles several edible mushroom species, increasing the risk of accidental poisoning. For example, it is similar to the paddy straw mushroom (Volvariella volvacea) and A. princeps, commonly known as "white Caesar".
There is currently no antidote to amanitin toxicity, and treatment focuses on immediate decontamination and supportive care. The prognosis for patients with amatoxin poisoning is often guarded to grave, even with early and aggressive treatment. Therefore, prevention by minimizing exposure to potentially toxic mushrooms is crucial.
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Amatoxins inhibit the RNA polymerase enzyme, impairing the liver's regenerative capacity
Amatoxins are toxic compounds found in certain species of mushrooms, notably those of the Amanita genus, such as Amanita phalloides and its variants. These toxins are responsible for the majority of fatal mushroom poisonings, with severe effects on the liver and other organs. Amatoxins are potent inhibitors of RNA polymerase II (RNA Pol II), a vital enzyme responsible for the synthesis of messenger RNA (mRNA), microRNA, and small nuclear RNA (snRNA).
Upon ingestion, amatoxins are absorbed in the gastrointestinal tract, with the liver being the first organ affected. Amatoxins accumulate in the liver due to uptake via organic anion-transporting polypeptides (OATP), particularly OATP1B3, located in the sinusoidal membrane of hepatocytes (liver cells). Once in the hepatocytes, amatoxins bind to and inhibit the activity of RNA polymerase II.
The inhibition of RNA polymerase II by amatoxins prevents mRNA synthesis and subsequent protein synthesis, leading to cell metabolism dysfunction and cell death (apoptosis). This disruption in liver cell function impairs the liver's regenerative capacity, as the cells are unable to effectively repair and regenerate, resulting in liver failure and potentially multi-organ failure.
The toxicity of amatoxins is further exacerbated by their high heat stability, solubility in water, and resistance to enzyme and acid degradation. They are not destroyed by cooking, drying, or the freeze-thaw process, making them exceptionally toxic. Treatment for amatoxin poisoning involves immediate decontamination, aggressive supportive care, and, in severe cases, orthotopic liver transplantation. However, due to the delay in symptom onset, often taking up to 24 hours, diagnosis and treatment can be challenging.
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Mushroom poisoning symptoms include nausea, vomiting, abdominal pain, and hallucinations
Mushroom poisoning is a significant health risk, especially in rural areas. There are over 5,000 species of mushrooms worldwide, but only 20-25% have been named, and only 3% of these are poisonous. However, due to underreporting, the exact incidence of mushroom poisoning is challenging to determine. Poisonous and non-poisonous mushrooms cannot be easily distinguished, and there is no simple test or defining characteristic to differentiate them. Therefore, it is crucial to consult a mushroom expert (mycologist) to identify a wild mushroom before consumption.
Mushroom poisoning symptoms typically occur within 2 to 24 hours of ingestion and include nausea, vomiting, abdominal pain, and hallucinations. Other symptoms may include severe gastrointestinal issues such as diarrhoea, abdominal cramps, and abdominal distress. In some cases, there may be a bitter taste in the mouth, headache, feelings of exhaustion, weakness, dizziness, sweating, and salivation. The onset of symptoms can vary depending on the type of mushroom and the toxins it contains. For example, the toxins in Omphalotus illudens and Omphalotus subilludins in North America can cause symptoms within one to three hours of ingestion, while Amanita phalloides, also known as the "death cap," can cause symptoms to appear 6 to 24 hours after consumption.
It is important to note that mushroom poisoning can have severe consequences, including liver and kidney failure, and even death. If you suspect mushroom poisoning, immediate medical attention is crucial, and prompt treatment can be life-saving. There is no antidote for amanitin poisoning, and early decontamination measures such as inducing vomiting and administering activated charcoal are essential to prevent further toxin absorption.
To prevent mushroom poisoning, it is important to avoid consuming wild mushrooms unless they have been identified as safe by a mushroom expert. Additionally, pet owners should remove wild mushrooms from their yards and keep their animals on a leash during walks in wooded areas to prevent accidental ingestion.
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Treatment for mushroom poisoning includes decontamination, IV fluids, and liver supplements
Mushroom poisoning occurs when someone ingests mushrooms that contain toxins. This often happens when toxic mushrooms are mistaken for nontoxic ones. While most ingested mushrooms are either nontoxic or only cause mild-to-moderate gastrointestinal irritation, certain types of mushrooms contain very potent toxins and are extremely poisonous. Amatoxins, for example, are responsible for 90% of fatal mushroom poisonings. They cause an asymptomatic incubation period followed by gastrointestinal and hepatotoxic phases, which can progress to multiorgan failure and death. Other toxins include coprine, which inhibits an enzyme required for breaking down alcohol, and gyromitrin, which causes neurotoxicity, gastrointestinal toxicity, and destruction of blood cells.
Treatment for mushroom poisoning depends on the type of toxin ingested and the severity of the poisoning. In some cases, hospitalization and aggressive support therapy, including IV fluids, can reduce the mortality rate to 10%. If the patient presents within an hour of ingestion, oral administration of activated charcoal may be considered to prevent the absorption of toxins. However, there is no evidence that administering multiple doses of activated charcoal is useful. Ipecac syrup is generally avoided, as vomiting often occurs spontaneously. Psychiatric care should be provided to patients with intentional ingestions and suicidal thinking.
In cases of severe poisoning, a liver or kidney transplant may be necessary to save the patient's life. However, in many cases, organs are not available, and even with aggressive treatment, mortality rates can be as high as 50-90% if treatment is delayed beyond 60 hours after ingestion. For certain toxins, such as gyromitrins, hemolysis can occur, requiring the administration of large amounts of IV fluids to prevent renal complications. In rare cases, dialysis may be needed if renal failure occurs.
To prevent mushroom poisoning, it is important to familiarize oneself with the mushrooms one intends to collect, as well as with any similar-looking toxic species. The safety of eating wild mushrooms may also depend on the methods of preparation for cooking, as some toxins, such as amatoxins, are thermostable and cannot be rendered safe by cooking.
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Mushroom identification is difficult, even for experts, and there is no simple test for toxicity
Mushroom poisoning is a significant health risk, especially in rural areas. It is believed that there are over 5,000 species of mushrooms worldwide, with only 20-25% of them named and only 3% of those being poisonous. However, due to the high number of underreported cases, the exact incidence of mushroom poisoning is challenging to determine.
Mushroom identification is a complex task, even for trained experts. There are no definitive methods for identification by foraging enthusiasts based on the mushroom's growing location, nearby trees, gills, or colour. For instance, the "death cap mushroom" (Amanita phalloides), which is responsible for the majority of mushroom-related deaths in the United States, resembles non-poisonous white button mushrooms. Therefore, it is crucial for those wishing to collect wild mushrooms to have the knowledge and expertise to distinguish their intended mushrooms from similar inedible or toxic species.
In cases of suspected mushroom ingestion, it is essential to seek expert assistance. The poison control centre can collaborate with local mycologists to identify a sample of the mushroom. If possible, it is helpful to provide an intact mushroom or a large fragment of the mushroom in a paper bag, along with photographs of the mushroom from various angles, including the top (cap), underside, and stem.
While most mushrooms are nontoxic or cause only mild gastrointestinal irritation, certain species, such as those containing amatoxins, can lead to severe liver damage and even death. Amatoxins selectively and irreversibly inhibit the RNA polymerase enzyme, impairing the liver's regenerative capacity and leading to potential liver failure. Unfortunately, there is currently no antidote to amanitin toxicity, and treatment focuses on immediate decontamination and supportive care. Therefore, prevention is of utmost importance, and individuals should avoid consuming wild mushrooms unless they are certain of their edibility.
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