Clinical toxicology (Philadelphia, Pa.) · 2025
Investigation of Amanita molliuscula poisoning outbreaks in Heilongjiang province, China.
СтатьяНазвание и аннотация: Перевод в очереди
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Song Li, Zhong Jiaju, Zhou Jing, Jin Hui, Jin Yihua, Gao Fei, Liu Zhongwei, Yuan Yuan, Zhang Yizhe, Li Zhongfeng, Cao Zhengjie, Sun Chengye, Li Haijiao
Аннотация
INTRODUCTION: In late August 2024, a cluster of cases of mushroom poisoning causing acute liver injury occurred in a county in Heilongjiang Province, China, resulting in two fatalities. This study aimed to identify the toxic mushroom species, quantify toxin concentrations, and characterize the clinical presentation and outcomes of the poisoning.
METHODS: We conducted a retrospective analysis of epidemiological data, clinical manifestations, and management approaches. The suspected mushrooms were identified using morphological and molecular techniques. The concentrations of six amatoxins in mushroom, blood, and urine samples were measured using ultra high-performance liquid chromatography-tandem mass spectrometry.
RESULTS: Eight mushroom poisoning outbreaks involving 19 individuals (11 males, eight females) from seven families were documented. Eighteen patients exhibited gastrointestinal symptoms, while one remained asymptomatic. Severe liver injury developed in 12 patients, including three who progressed to liver failure; two of these patients died, and the third recovered following liver transplantation. The causative mushroom was identified as Amanita molliuscula, which had been mistaken for the edible Agaricus bisporus. Both mushroom and biological samples tested positive for α-amanitin and β-amanitin.
DISCUSSION: As far as we are aware, these are the first detailed reported outbreaks of Amanita molliuscula poisoning. The high mortality (two deaths) and need for liver transplantation in one patient underscore the severe toxicity of this species and the life-threatening nature of its poisoning.
CONCLUSION: Amanita molliuscula contains α-amanitin and β-amanitin in this region of China, with hepatotoxicity as the primary clinical manifestation. Fulminant liver failure was the leading cause of death, though liver transplantation proved effective in one case. Given that toxic wild mushrooms often resemble edible varieties and cannot be reliably distinguished visually, improved public education and surveillance are crucial to mitigating the risks associated with wild mushroom consumption.
METHODS: We conducted a retrospective analysis of epidemiological data, clinical manifestations, and management approaches. The suspected mushrooms were identified using morphological and molecular techniques. The concentrations of six amatoxins in mushroom, blood, and urine samples were measured using ultra high-performance liquid chromatography-tandem mass spectrometry.
RESULTS: Eight mushroom poisoning outbreaks involving 19 individuals (11 males, eight females) from seven families were documented. Eighteen patients exhibited gastrointestinal symptoms, while one remained asymptomatic. Severe liver injury developed in 12 patients, including three who progressed to liver failure; two of these patients died, and the third recovered following liver transplantation. The causative mushroom was identified as Amanita molliuscula, which had been mistaken for the edible Agaricus bisporus. Both mushroom and biological samples tested positive for α-amanitin and β-amanitin.
DISCUSSION: As far as we are aware, these are the first detailed reported outbreaks of Amanita molliuscula poisoning. The high mortality (two deaths) and need for liver transplantation in one patient underscore the severe toxicity of this species and the life-threatening nature of its poisoning.
CONCLUSION: Amanita molliuscula contains α-amanitin and β-amanitin in this region of China, with hepatotoxicity as the primary clinical manifestation. Fulminant liver failure was the leading cause of death, though liver transplantation proved effective in one case. Given that toxic wild mushrooms often resemble edible varieties and cannot be reliably distinguished visually, improved public education and surveillance are crucial to mitigating the risks associated with wild mushroom consumption.