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Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report

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Resumo:Mushroom poisonings occur when ingestion of wild mushrooms containing toxins takes place, placing the consumers at life-threatening risk. In the present case report, an unusual multiple poisoning with isoxazoles- and amatoxins-containing mushrooms in a context of altered mental state and poorly controlled hypertension is presented. A 68-year-old female was presented to São João hospital (Portugal) with complaints of extreme dizziness, hallucinations, vertigo and imbalance, 3 h after consuming a stew of wild mushrooms. The first observations revealed altered mental state and elevated blood pressure. The examination of cooked mushroom fragments allowed a preliminary identification of Amanita pantherina. Gas chromatography-mass spectrometry (GC-MS) showed the presence of muscimol in urine. Moreover, through high-performance liquid chromatography-ultraviolet detection (HPLC-UV) analysis of the gastric juice, the presence of α-amanitin was found, showing that amatoxins-containing mushrooms were also included in the stew. After 4 days of supportive treatment, activated charcoal, silybin and N-acetylcysteine, the patient recovered being discharged 10 days post-ingestion with no organ complications. The prompt and appropriate therapy protocol for life-threatening amatoxins toxicity probably saved the patient's life as oral absorption was decreased and also supportive care was immediately started.
Autores principais:Garcia, Juliana
Outros Autores:Costa, Vera M.; Costa, Ana Elisa; Andrade, Sérgio; Carneiro, Ana Cristina; Conceição, Filipe; Paiva, José Artur; Pinho, P. Guedes de; Baptista, Paula; Bastos, Maria de Lourdes; Carvalho, Félix
Assunto:Amanita pantherina Amanita phalloides Amatoxins Intoxication Isoxazoles Wild mushrooms
Ano:2015
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Instituto Politécnico de Bragança
Idioma:inglês
Origem:Biblioteca Digital do IPB
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author Garcia, Juliana
author2 Costa, Vera M.
Costa, Ana Elisa
Andrade, Sérgio
Carneiro, Ana Cristina
Conceição, Filipe
Paiva, José Artur
Pinho, P. Guedes de
Baptista, Paula
Bastos, Maria de Lourdes
Carvalho, Félix
author2_role author
author
author
author
author
author
author
author
author
author
author_facet Garcia, Juliana
Costa, Vera M.
Costa, Ana Elisa
Andrade, Sérgio
Carneiro, Ana Cristina
Conceição, Filipe
Paiva, José Artur
Pinho, P. Guedes de
Baptista, Paula
Bastos, Maria de Lourdes
Carvalho, Félix
author_role author
contributor_name_str_mv Biblioteca Digital do IPB
country_str PT
creators_json_str [{\"Person.name\":\"Garcia, Juliana\"},{\"Person.name\":\"Costa, Vera M.\"},{\"Person.name\":\"Costa, Ana Elisa\"},{\"Person.name\":\"Andrade, Sérgio\"},{\"Person.name\":\"Carneiro, Ana Cristina\"},{\"Person.name\":\"Conceição, Filipe\"},{\"Person.name\":\"Paiva, José Artur\"},{\"Person.name\":\"Pinho, P. Guedes de\"},{\"Person.name\":\"Baptista, Paula\",\"Person.identifier.orcid\":\"0000-0001-6331-3731\"},{\"Person.name\":\"Bastos, Maria de Lourdes\"},{\"Person.name\":\"Carvalho, Félix\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Biblioteca Digital do IPB
datacite.creators.creator.creatorName.fl_str_mv Garcia, Juliana
Costa, Vera M.
Costa, Ana Elisa
Andrade, Sérgio
Carneiro, Ana Cristina
Conceição, Filipe
Paiva, José Artur
Pinho, P. Guedes de
Baptista, Paula
Bastos, Maria de Lourdes
Carvalho, Félix
datacite.date.Accepted.fl_str_mv 2015-01-01T00:00:00Z
datacite.date.available.fl_str_mv 2018-01-19T10:00:00Z
datacite.date.embargoed.fl_str_mv 2018-01-19T10:00:00Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
datacite.titles.title.fl_str_mv Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
dc.contributor.none.fl_str_mv Biblioteca Digital do IPB
dc.creator.none.fl_str_mv Garcia, Juliana
Costa, Vera M.
Costa, Ana Elisa
Andrade, Sérgio
Carneiro, Ana Cristina
Conceição, Filipe
Paiva, José Artur
Pinho, P. Guedes de
Baptista, Paula
Bastos, Maria de Lourdes
Carvalho, Félix
dc.date.Accepted.fl_str_mv 2015-01-01T00:00:00Z
dc.date.available.fl_str_mv 2018-01-19T10:00:00Z
dc.date.embargoed.fl_str_mv 2018-01-19T10:00:00Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10198/16113
dc.language.none.fl_str_mv eng
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
dc.title.fl_str_mv Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Mushroom poisonings occur when ingestion of wild mushrooms containing toxins takes place, placing the consumers at life-threatening risk. In the present case report, an unusual multiple poisoning with isoxazoles- and amatoxins-containing mushrooms in a context of altered mental state and poorly controlled hypertension is presented. A 68-year-old female was presented to São João hospital (Portugal) with complaints of extreme dizziness, hallucinations, vertigo and imbalance, 3 h after consuming a stew of wild mushrooms. The first observations revealed altered mental state and elevated blood pressure. The examination of cooked mushroom fragments allowed a preliminary identification of Amanita pantherina. Gas chromatography-mass spectrometry (GC-MS) showed the presence of muscimol in urine. Moreover, through high-performance liquid chromatography-ultraviolet detection (HPLC-UV) analysis of the gastric juice, the presence of α-amanitin was found, showing that amatoxins-containing mushrooms were also included in the stew. After 4 days of supportive treatment, activated charcoal, silybin and N-acetylcysteine, the patient recovered being discharged 10 days post-ingestion with no organ complications. The prompt and appropriate therapy protocol for life-threatening amatoxins toxicity probably saved the patient's life as oral absorption was decreased and also supportive care was immediately started.
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eu_rights_str_mv openAccess
format article
fulltext.url.fl_str_mv https://bibliotecadigital.ipb.pt/bitstreams/5a6f37af-ddf0-4fb0-9609-8795b6d59269/download
id ipb_ac57eff9bc8d8ec2f4121c7ecd9f9739
identifier.url.fl_str_mv http://hdl.handle.net/10198/16113
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institution Instituto Politécnico de Bragança
instname_str Instituto Politécnico de Bragança
language eng
network_acronym_str ipb
network_name_str Biblioteca Digital do IPB
oai_identifier_str oai:bibliotecadigital.ipb.pt:10198/16113
organization_str_mv urn:organizationAcronym:ipb
person_str_mv Garcia, Juliana
Costa, Vera M.
Costa, Ana Elisa
Andrade, Sérgio
Carneiro, Ana Cristina
Conceição, Filipe
Paiva, José Artur
Pinho, P. Guedes de
Baptista, Paula
Baptista, Paula
https://www.ciencia-id.pt/7D11-FE1E-CD0F
7D11-FE1E-CD0F
http://orcid.org/0000-0001-6331-3731
0000-0001-6331-3731
Bastos, Maria de Lourdes
Carvalho, Félix
publishDate 2015
reponame_str Biblioteca Digital do IPB
repository_id_str urn:repositoryAcronym:ipb
service_str_mv urn:repositoryAcronym:ipb
spelling engen_ENMushroom poisonings occur when ingestion of wild mushrooms containing toxins takes place, placing the consumers at life-threatening risk. In the present case report, an unusual multiple poisoning with isoxazoles- and amatoxins-containing mushrooms in a context of altered mental state and poorly controlled hypertension is presented. A 68-year-old female was presented to São João hospital (Portugal) with complaints of extreme dizziness, hallucinations, vertigo and imbalance, 3 h after consuming a stew of wild mushrooms. The first observations revealed altered mental state and elevated blood pressure. The examination of cooked mushroom fragments allowed a preliminary identification of Amanita pantherina. Gas chromatography-mass spectrometry (GC-MS) showed the presence of muscimol in urine. Moreover, through high-performance liquid chromatography-ultraviolet detection (HPLC-UV) analysis of the gastric juice, the presence of α-amanitin was found, showing that amatoxins-containing mushrooms were also included in the stew. After 4 days of supportive treatment, activated charcoal, silybin and N-acetylcysteine, the patient recovered being discharged 10 days post-ingestion with no organ complications. The prompt and appropriate therapy protocol for life-threatening amatoxins toxicity probably saved the patient's life as oral absorption was decreased and also supportive care was immediately started.application/pdfen_ENCo-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case reportGarcia, JulianaCosta, Vera M.Costa, Ana ElisaAndrade, SérgioCarneiro, Ana CristinaConceição, FilipePaiva, José ArturPinho, P. Guedes dePersonalBaptista, PaulaDSpacehttp://dspace.org/items/3f35226a-b17a-4f7d-8da1-3297105cbfe9DSpacehttp://dspace.org/items/3f35226a-b17a-4f7d-8da1-3297105cbfe9BaptistaPaulaCiência IDhttps://www.ciencia-id.pt7D11-FE1E-CD0FORCIDhttp://orcid.org0000-0001-6331-3731Scopus Author IDhttps://www.scopus.com14051688000Scopus Author IDhttps://www.scopus.com57394839600Bastos, Maria de LourdesCarvalho, FélixHostingInstitutionOrganizationalBiblioteca Digital do IPBe-mailmailto:dspace@ipb.ptdspace@ipb.ptISSNIsPartOf0041-0101DOIIsPartOf10.1016/j.toxicon.2015.06.0122018-01-19T10:00:00Z20152015-01-01T00:00:00ZHandlehttp://hdl.handle.net/10198/16113http://purl.org/coar/access_right/c_abf2open accessAmanita pantherinaAmanita phalloidesAmatoxinsIntoxicationIsoxazolesWild mushrooms746070 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://bibliotecadigital.ipb.pt/bitstreams/5a6f37af-ddf0-4fb0-9609-8795b6d59269/download
spellingShingle Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
Garcia, Juliana
Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
subject.fl_str_mv Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
title Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
title_full Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
title_fullStr Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
title_full_unstemmed Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
title_short Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
title_sort Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report
topic Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
topic_facet Amanita pantherina
Amanita phalloides
Amatoxins
Intoxication
Isoxazoles
Wild mushrooms
url http://hdl.handle.net/10198/16113
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