scholarly journals Nephrotoxic Mushroom Poisoning: Global Epidemiology, Clinical Manifestations, and Management

2021 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Clinical Manifestations ◽  
Mushroom Poisoning ◽  
Global Epidemiology

scholarly journals Prognosis and treatment options in cases of acute liver failure caused by mushroom poisoning due to Amanita phalloides

2020 ◽  
Vol 7 (5) ◽  
pp. 875
Author(s):  
Anant Parasher ◽  
Akshay Aggrawal
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Orthotopic Liver Transplantation ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Amanita Phalloides ◽  
Penicillin G ◽  
Mushroom Poisoning ◽  
Mushroom Ingestion

Poisoning due to mushroom ingestion is a relatively rare but deadly cause of acute liver failure (ALF). Consumption of the poisonous mushroom Amanita phalloides, also known as ‘death cap’, is one of the most common causes of mushroom poisoning worldwide, being involved in the majority of human fatalities caused due to mushroom ingestion. A major portion of the liver damage due to Amanita phalloides is related to powerful toxins known as amanitins, which cause impairment in protein synthesis and subsequent cell necrosis by the inhibition of RNA polymerase II. Initially the presentation is that of an asymptomatic lag phase, followed by gastrointestinal symptoms and hepato-renal involvement. Amatoxin poisoning may progress into fulminant hepatic failure and eventually death if liver transplantation is not performed. It is based on a careful assessment of history of type and duration of mushroom ingestion, as well as the clinical manifestations. Diagnosis can be confirmed by laboratory tests measuring urinary amatoxin levels and identification of the mushroom. Although N-Acetyl Cysteine and Penicillin-G have proven to be effective therapeutic agents, Orthotopic Liver Transplantation (OLT) or Auxiliary Partial Orthotopic Liver Transplantation (APOLT) is the only treatment option for most of the cases carrying a poor prognosis.

scholarly journals Atopic Dermatitis: Global Epidemiology and Risk Factors

2015 ◽  
Vol 66 (Suppl. 1) ◽  
pp. 8-16 ◽  
Author(s):  
Sophie Nutten
Keyword(s):  
Risk Factors ◽  
Atopic Dermatitis ◽  
Low Income ◽  
Skin Disease ◽  
Complex Disease ◽  
Symptom Control ◽  
Clinical Manifestations ◽  
Low Income Countries ◽  
Skin Barrier Function ◽  
Global Epidemiology

Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention.

scholarly journals Chlorophyllum Molybdites “Delicious Poisoning Snack” in Patients Diagnosed with Acute Gastroenteritis

2021 ◽  
Vol 5 ◽  
pp. 17
Author(s):  
Zainul Ikhwan Ahmad Khusairi ◽  
Rizz Fazali ◽  
Chung WM ◽  
Azmir Anuar ◽  
Afendi Ghazali
Keyword(s):  
Acute Gastroenteritis ◽  
Clinical Manifestations ◽  
Medical Emergency ◽  
Mushroom Poisoning ◽  
Human Diet ◽  
History Of ◽  
Medicinal Properties ◽  
Poisonous Mushrooms ◽  
Alpha Amanitin ◽  
Mushroom Ingestion

Introduction: Since time immemorial, mushrooms have been used as a part of human diet, some of them are very well known for their nutritive and medicinal properties and some are known to cause poisoning to the human body. A number of post ingestion fatalities due to poisonous mushrooms has been reported worldwide. These poisonous mushrooms are often misidentified as edible ones, which accounts for accidental poisoning.Objective: The main objective of this report was to describe the clinical manifestations of mushroom poisoning cases presented at the Emergency Department (ED), Taiping Hospital.Case Presentation: There were two cases presented, who suffered from moderate dehydration due to acute gastroenteritis after taking 'delicious mushrooms', also known as Chlorophyllum Molybdites. This study found that both cases had complaints of abdominal cramping, diarrhoea and vomiting more than twenty times a day. There was no history of numbness or weakness noted, and no chest pain or shortness of breath. On arrival, both cases presented signs of moderate dehydration with coated tongue and normal blood pressure, with slightly increased in temperature (37.30C). Abdomen was soft but discomfort upon palpation and described as bloated. Both cases were resuscitated with 20ml/kg normal saline. Charcoal, antiemetic, proton pump inhibitor and ceftriaxone antibiotic were given at the ED. Both survived and were treated as infectious acute gastroenteritis. Nausea and vomiting were the most common early symptoms of intoxication and should be considered as a medical emergency. Alpha Amanitin levels should be checked where possible if amanita poisoning is suspected. An early diagnosis and immediate treatment are required for a successful outcome.Conclusion: All patients with the history of mushroom ingestion should be admitted. If laboratory detection of toxin is not available, history of mushroom ingestion, clinical manifestation and their trends could define mushroom poisoning.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S17

scholarly journals Acute liver failure caused by Amanita verna: a case series and review of the literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianlong Wu ◽  
Xueyi Gong ◽  
Zemin Hu ◽  
Qiang Sun
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Toxic Hepatitis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Toxic Encephalopathy ◽  
Mushroom Poisoning ◽  
Wild Mushrooms ◽  
Case Presentation

Abstract Background Amanita verna is one of the most harmful wild fungi in China. Amanita verna poisoning occurs every year, and the mortality is as high as 50%. However, its clinical manifestations are complex and diverse. Case presentation In March 2019, three patients took a large amount of Amanita, and one of them received liver transplantation in Zhongshan hospital, Sun Yat-sen University. All patients had vomiting and diarrhea 8–12 h after eating wild mushrooms (Amanita). The patients were initially diagnosed with Amanita poisoning. One case (case 3) was complicated and diagnosed as mushroom poisoning (fatal Amanita), toxic hepatitis, acute liver failure, toxic encephalopathy, hemorrhagic colitis, toxic myocarditis, disseminated intravascular coagulation (DIC) and pregnancy. The general clinical data of all patients were recorded, who received early treatment such as hemodialysis, artificial liver plasma exchange, hormone shock and anti-infection. One case (case 1) recovered smoothly after liver transplantation, and the indexes of liver, kidney, coagulation function and infection were improved. The other two cases died of intracerebral hemorrhage. Conclusion Liver transplantation is an effective method for the treatment of acute liver failure caused by mushroom poisoning and can improve the survival rate of patients with toxic liver failure.

Investigating and analyzing three cohorts of mushroom poisoning caused by Amanita exitialis in Yunnan, China

2017 ◽  
Vol 37 (7) ◽  
pp. 665-678 ◽  
Author(s):  
J Sun ◽  
H-J Li ◽  
H-S Zhang ◽  
Y-Z Zhang ◽  
J-W Xie ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Latency Period ◽  
Ultra Performance Liquid Chromatography ◽  
Average Concentration ◽  
Mushroom Poisoning ◽  
Survival Group ◽  
The Public ◽  
Laboratory Examinations ◽  
Peptide Toxins ◽  
Death Group

Amanita exitialis is a lethal mushroom found in China. Knowledge regarding taxonomic characterization, toxin detection, general poisoning conditions, clinical manifestations, laboratory examinations, and clinical treatments for this species is currently lacking. We investigated three A. exitialis mushroom poisoning cohorts in Yunnan Province in 2014 and 2015, involving 10 patients. Mushroom samples were identified by morphological and molecular studies. Ultra performance liquid chromatography-electrospray ionization tandem mass spectrometry was used to detect the peptide toxins in the mushroom samples. Epidemiological information, clinical data, and results of laboratory examinations were collected and analyzed. The mushroom samples were all identified as A. exitialis. The average toxin concentration decreased from the cap to the stipe to the volva, and the average concentration of the peptide toxins decreased in the order of α-amanitin > phallacidin > β-amanitin > γ-amanitin. The latency period between ingestion and the onset of symptoms was 13.9 ± 2.1 h, and the time from ingestion to hospitalization was 49.6 ± 8.5 h. The most common symptoms were nausea and vomiting (100%). Four patients died from fulminant hepatic failure. Laboratory examinations showed that the alanine transaminase, aspartate transaminase, prothrombin time, and activated partial thromboplastin time levels peaked on the third day post-ingestion. Total bilirubin and direct bilirubin values peaked on day 7. The death group and the survival group had a similar variation trend of serological indexes, but the death group had a greater change. A. exitialis is an extremely dangerous mushroom and there is a need to educate the public to avoid picking and eating wild mushrooms that have not been definitively identified.

Morphologic alteration in the muscles of patients with hypokalemic periodic paralysis or myopathy

1990 ◽  
Vol 48 (3) ◽  
pp. 222-223
Author(s):  
T. Shimizu ◽  
Y. Muranaka ◽  
I. Ohta ◽  
N. Honda
Keyword(s):  
Clinical Manifestations ◽  
Quadriceps Muscle ◽  
Honeycomb Structure ◽  
Periodic Paralysis ◽  
Ultrastructural Changes ◽  
Hypokalemic Periodic Paralysis ◽  
Electron Microscopic ◽  
Tubular Aggregates ◽  
Hypokalemic Myopathy ◽  
Transmission Electron

There have been many reports on ultrastructural alterations in muscles of hypokalemic periodic paralysis (hpp) and hypokalemic myopathy(hm). It is stressed in those reports that tubular structures such as tubular aggregates are usually to be found in hpp as a characteristic feature, but not in hm. We analyzed the histological differences between hpp and hm, comparing their clinical manifestations and morphologic changes in muscles. Materials analyzed were biopsied muscles from 18 patients which showed muscular symptoms due to hypokalemia. The muscle specimens were obtained by means of biopsy from quadriceps muscle and fixed with 2% glutaraldehyde (pH 7.4) and analyzed by ordinary method and modified Golgimethod. The ultrathin section were examined in JEOL 200CX transmission electron microscopy.Electron microscopic examinations disclosed dilated t-system and terminal cistern of sarcoplasmic reticulum (SR)(Fig 1), and an unique structure like “sixad” was occasionally observed in some specimens (Fig 2). Tubular aggregates (Fig 3) and honeycomb structure (Fig 4) were also common characteristic structures in all cases. These ultrastructural changes were common in both the hypokalemic periodic paralysis and the hypokalemic myopathy, regardless of the time of biopsy or the duration of hypokalemia suffered.

Nutritional B12 Deficiency in Infants of Vitamin B12-Deficient Mothers

2011 ◽  
Vol 81 (5) ◽  
pp. 328-334 ◽  
Author(s):  
Oya Halicioglu ◽  
Sezin Asik Akman ◽  
Sumer Sutcuoglu ◽  
Berna Atabay ◽  
Meral Turker ◽  
...  
Keyword(s):  
Megaloblastic Anemia ◽  
Maternal Diet ◽  
Clinical Manifestations ◽  
Serum Vitamin ◽  
Failure To Thrive ◽  
Clinical Findings ◽  
Vitamin B ◽  
Animal Products ◽  
Hematological Evaluation ◽  
Nutritional Vitamin

Aim: Nutritional vitamin B12 deficiency in infants may occur because the maternal diet contains inadequate animal products. Clinical presentations of the infants who had nutritional vitamin B12 deficiency were analyzed in this study. Subjects and Methods: Patients with nutritional vitamin B12 deficiency were enrolled in the study between 2003 and 2010. The diagnosis was based on a nutritional history of mothers and infants, clinical findings, hematological evaluation, and low level of serum vitamin B12. Results: Thirty children aged 1 - 21 months constituted the study group. Poverty was the main cause of inadequate consumption of animal products of the mothers. All infants had predominantly breastfed. The most common symptoms were developmental delay, paleness, apathy, lethargy, anorexia, and failure to thrive. Hematological findings were megaloblastic anemia (83.3 %), thrombocytopenia (30 %), and severe anemia (13.3 %). All of the mothers had low serum B12 levels; eight of them had megaloblastic anemia. Conclusion: The unusual clinical manifestations of vitamin B12 deficiency may also be seen apart from neurological and hematological findings. Nutritional vitamin B12 deficiency due to maternal deficiency might be a serious health problem in infants. Therefore, screening and supplementation of pregnant and lactating women to prevent infantile vitamin B12 deficiency should be considered.

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