A Case of Mushroom Poisoning with <i>Russula subnigricans</i>: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death

Cho, Jong Tae; Han, Jin Hyung

doi:10.3346/jkms.2016.31.7.1164

Cited by 30 publications

(29 citation statements)

References 18 publications

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“…As some potentially harmful effects have been observed in species that are classified as edible, inedible, or poisonous, it is sometimes difficult to establish clear demarcations between edible and poisonous species. Regarding striated muscle damage, Russula subnigricans, that is classified as poisonous, triggered rhabdomyolysis in Asia, which was quite similar to the cases reported for T. equestre and A. bisporus [ 32 , 33 ].…”

Section: Are Edible Mushrooms Really Edible?supporting

confidence: 71%

Toxic Potential of Traditionally Consumed Mushroom Species—A Controversial Continuum with Many Unanswered Questions

Nieminen

Mustonen

2020

Toxins

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Mushroom poisonings remain a significant cause of emergency medicine. While there are well-known species, such as Amanita phalloides, causing life-threatening poisonings, there is also accumulating evidence of poisonings related to species that have been considered edible and are traditionally consumed. In particular, the Tricholoma equestre group was reported to cause myotoxicity. In addition, particular wild mushrooms that are traditionally consumed especially in Asia and Eastern Europe have been subject to suspicion due to possible mutagenicity. Hitherto, the causative agents of these effects often remain to be determined, and toxicity studies have yielded contradictory results. Due to this, there is no consensus about the safety of these species. The issue is further complicated by difficulties in species identification and other possible sources of toxicity, such as microbiological contamination during storage, leading to sometimes opposite conclusions about the edibility of a species. This review focuses on existing data about these types of mushroom poisonings, including the still sparse knowledge about the causative chemical agents. In addition, the aim is to initiate a meta-discussion about the issue and to give some suggestions about how to approach the situation from the viewpoint of the collector, the researcher, and the practicing physician.

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Section: Are Edible Mushrooms Really Edible?supporting

confidence: 71%

Toxic Potential of Traditionally Consumed Mushroom Species—A Controversial Continuum with Many Unanswered Questions

Nieminen

Mustonen

2020

Toxins

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“…This has occurred in Europe and Asia after consumption of wild mushrooms. [6][7][8][25][26][27] The actual chemical substances causing muscle toxicity remain unknown for the edible fungi and T. flavovirens/equestre but R. subnigricans is known to contain cycloprop-2-ene carboxylic acid that triggers rhabdomyolysis. 28 The main finding of the present study was that F. velutipes consumption induced elevated levels of plasma CK at 6-9 g/kg/d.…”

Section: Discussionmentioning

confidence: 99%

Myo- and cardiotoxic effects of the wild winter mushroom (Flammulina velutipes) on mice

Mustonen

Määttänen

Kärjä

et al. 2018

Exp Biol Med (Maywood)

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Rhabdomyolysis (destruction of striated muscle) is a novel form of mushroom poisoning in Europe and Asia indicated by increased circulating creatine kinase levels. Particular wild fungi have also been reported to induce elevated creatine kinase activities in mice. Flammulina velutipes (enokitake or winter mushroom) is one of the most actively cultivated mushroom species globally. As it is marketed as a medicinal mushroom and functional food, it is important to examine whether it could induce potentially harmful health effects similar to some previously studied edible fungi. The present study examined the effects of F. velutipes consumption on the plasma clinical chemistry, hematology, and organ histology of laboratory mice. Wild F. velutipes were dried, pulverized, mixed with a regular laboratory rodent diet, and fed to the animals at 0, 3, 6, or 9 g/kg body mass/day for five days ( n = 6/group). F. velutipes consumption caused increased activities of plasma creatine kinase and the MB-fraction of creatine kinase at 6-9 g/kg/d, indicating potentially deleterious effects on both skeletal and cardiac muscle. The plasma total and high-density lipoprotein cholesterol concentrations (at 9 g/kg/d) and white blood cell and lymphocyte counts (at 6-9 g/kg/d) decreased. Although the cholesterol-lowering properties of F. velutipes can be beneficial, the previously unexamined, potentially hazardous side effects of mushroom consumption (myo- and cardiotoxicity) should be thoroughly investigated before recommending this mushroom species as a health-promoting food item. Impact statement This work is important to the field of functional foods, as it provides novel information about the potential myo- and cardiotoxic properties of an edible mushroom, Flammulina velutipes. The results are useful and of importance because F. velutipes is an actively cultivated mushroom and marketed as a health-promoting food item. The findings contribute to the understanding of the complexity of the balance between the beneficial and potentially harmful effects of mushroom consumption.

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“…14,15 One study in humans did not find evidence of T. equestre toxicity and support that T. equestre is edible if ingested in reasonable amounts by healthy people. 15 Mushroom poisoning with rapid onset myotoxicity is associated with ingestion of selected Russula species, including R. subnigricans 2,[16][17][18] or Russula subnigricans Hongo. The causative toxin has been reported as a highly strained carboxylic acid, cycloprop-2-ene carboxylic acid.…”

Section: Introductionmentioning

confidence: 99%

“…20 Clinically, myotoxic mushroom-poisoned patients typically present with fatigue, myalgia, muscle weakness and dark urine representing rhabdomyolysis, with or without obvious gastrointestinal (GI) symptoms. [8][9][10][11][16][17][18] Some patients with severe illness develop acute renal failure, electrolyte disturbances (hyperkalaemia, hypocalcaemia), respiratory failure, acute myocarditis, cardiac arrhythmias, pulmonary oedema, cardiac failure or cardiovascular collapse. 8,11,[16][17][18] Fatalities have been reported from myotoxic mushroom poisoning.…”

Section: Introductionmentioning

confidence: 99%

<p>Myotoxic Mushroom Poisoning in Thailand: Clinical Characteristics and Outcomes</p>

Trakulsrichai¹,

Jeeratheepatanont²,

Sriapha³

et al. 2020

IJGM

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A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death

Cited by 30 publications

References 18 publications

Toxic Potential of Traditionally Consumed Mushroom Species—A Controversial Continuum with Many Unanswered Questions

Toxic Potential of Traditionally Consumed Mushroom Species—A Controversial Continuum with Many Unanswered Questions

Myo- and cardiotoxic effects of the wild winter mushroom (Flammulina velutipes) on mice

<p>Myotoxic Mushroom Poisoning in Thailand: Clinical Characteristics and Outcomes</p>

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