Clinical manifestations of amanita subjunquillea poisoning / 대한내과학회지

ABSTRACT

BACKGROUND: To the best of our knowledge, the report on Amanita subjunquillea poisoning has not been found in the medical literature. We investigated the clinical aspects of Amanita subjunquillea poisoning. METHODS: Sixteen subjects who had ingested the mushroom (A. subjunquillea) were examined for clinical features, laboratory and radiologic findings prospectively. RESULTS: The mean incubation period was 11.5 hours(range 3 to 17 hours). The initial presentations were gastrointestinal symptoms which persisted for 2 to 4 days. The transaminase levels were elevated in all subjects and peaked on day 3 after ingestion of the mushrooms (mean AST/ALT levels 3241 IU/L and 3741 IU/L, respectively). Biochemical evidence of pancreatitis and disseminated intravascular coagulation were frequent (83.3% and 62.5%, respectively). Liver ultrasonography and scintigraphy revealed abnormalities in most cases. Massive hepatic necrosis was confirmed by liver biopsy in one subject. The overall mortality was 12.5%. CONCLUSION: Clinical manifestations of A. subjunquillea poisoning were similar to those of other poisonous Amanitaceae intoxication. However, the mortality rate was lower in A. subjunquillea poisoning. Our data showed strong evidence that A. subjunquillea should be classified in the group of poisonous mushrooms.