Phalloides Syndrome Poisoning After Ingestion of <i>Lepiota</i> Mushrooms

Kervégant, Morgane; Haro, Luc de; Patat, Anne Marie; Pons, Charlotte; Thomachot, Laurent; Minodier, Philippe

doi:10.1016/j.wem.2012.11.002

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…Although 14 of 27 intoxicated patients monitored by Paydas et al 14 lost their lives as a result of liver failure, the publication stressed that there were no deaths associated with renal failure. In the case reported by Kervégant et al 16 relating to a child who was discharged on day 11, the child’s AST and ALT values (1018 IU/L and 3205 IU/L, respectively) increased, and PT time was prolonged (18 seconds). However, the child’s transaminase values were not elevated as high as those of our patient.…”

Section: Discussionmentioning

confidence: 94%

A Case Study: Rare Lepiota brunneoincarnata Poisoning

Köse

Yılmaz

Akata

et al. 2015

Wilderness & Environmental Medicine

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Amatoxin poisoning from the genus Lepiota may have a deadly outcome, although this is not seen as often as it is from the genus Amanita. In this report, we present a patient who was poisoned by a sublethal dose of Lepiota brunneoincarnata mushrooms. The patient was hospitalized 12 hours after eating the mushrooms. The patient's transaminase levels increased dramatically starting on day 4. Aspartate transaminase peaked at 78 hours. Starting at 1265 IU/L, alanine transaminase peaked at 90 hours at 5124 IU/L. The patient was discharged on day 8 to outpatient care, and his transaminase levels returned to normal ranges in the subsequent days. A toxin analysis was carried out on the mushrooms that the patient claimed to have eaten. Using reversed-phase high-performance liquid chromatography analysis, an uptake of approximately 19.9 mg of amatoxin from nearly 30 g of mushrooms was calculated. This consisted of 10.59 mg of α-amanitin, 9.18 mg of β-amanitin, and 0.16 mg of γ-amanitin. In conclusion, we present a patient from Turkey who was poisoned by L. brunneoincarnata mushrooms.

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Section: Discussionmentioning

confidence: 94%

A Case Study: Rare Lepiota brunneoincarnata Poisoning

Köse

Yılmaz

Akata

et al. 2015

Wilderness & Environmental Medicine

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“…Although species of Amanita , such as A. phalloides , A. verna , A. virosa , A. ocreata , and A. bisporigera , are the most notorious source of amatoxins and account for most fatal mushroom poisonings, deaths have also been attributed to the ingestion of amatoxin-containing species of Lepiota , a genus of small, saprobic mushrooms of worldwide distribution [6,7,8,9,10,11,12]. However, in contrast to Amanita , there have been relatively few analyses of the toxic peptide composition of Lepiota mushrooms, and to the best of our knowledge none using modern high resolution methods.…”

Section: Introductionmentioning

confidence: 99%

Profiling of Amatoxins and Phallotoxins in the Genus Lepiota by Liquid Chromatography Combined with UV Absorbance and Mass Spectrometry

Sgambelluri

Epis

Sassera

et al. 2014

Toxins

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Species in the mushroom genus Lepiota can cause fatal mushroom poisonings due to their content of amatoxins such as α-amanitin. Previous studies of the toxin composition of poisonous Lepiota species relied on analytical methods of low sensitivity or resolution. Using liquid chromatography coupled to UV absorbance and mass spectrometry, we analyzed the spectrum of peptide toxins present in six Italian species of Lepiota, including multiple samples of three of them collected in different locations. Field taxonomic identifications were confirmed by sequencing of the internal transcribed spacer (ITS) regions. For comparison, we also analyzed specimens of Amanita phalloides from Italy and California, a specimen of A. virosa from Italy, and a laboratory-grown sample of Galerina marginata. α-Amanitin, β-amanitin, amanin, and amaninamide were detected in all samples of L. brunneoincarnata, and α-amanitin and γ-amanitin were detected in all samples of L. josserandii. Phallotoxins were not detected in either species. No amatoxins or phallotoxins were detected in L. clypeolaria, L. cristata, L. echinacea, or L. magnispora. The Italian and California isolates of A. phalloides had similar profiles of amatoxins and phallotoxins, although the California isolate contained more β-amanitin relative to α-amanitin. Amaninamide was detected only in A. virosa.

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“…In fact, although several Amanita species represent the most notorious source of amatoxins and are responsible for most fatal mushroom poisonings worldwide (Enjalbert et al, 2002;Tang et al, 2016;Wei et al, 2017;Diaz, 2018;Walton, 2018), fatal intoxications after ingestion of amatoxin-containing species of Lepiota also occur (Sgambelluri et al, 2014;Diaz, 2018). Lepiota poisonings have been reported in Europe, America, Asia, and North Africa (Tunisia) (Paydas et al, 1990;Watling, 1991;Ramirez et al, 1993;Khelil et al, 2010;Kervégant et al, 2013;Kose et al, 2015;Cai et al, 2018;Diaz, 2018;Sun et al, 2019), and the most frequently reported fatal cases are due to L. brunneoincarnata and L. subincarnata (Roux et al, 2008;Khelil et al, 2010;Mottram et al, 2010;Diaz, 2018;Sun et al, 2019). Lethal Lepiota species usually produce more than one type of amatoxin, for example, L. brunneoincarnata contains both αand β-amanitin (Yilmaz et al, 2015), whereas αand γ-amanitin are present in L. josserandii (Sgambelluri et al, 2014;Walton, 2018).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

First Report of a Neotropical Agaric (Lepiota spiculata, Agaricales, Basidiomycota) Containing Lethal α-Amanitin at Toxicologically Relevant Levels

Angelini¹,

Vizzini

Justo³

et al. 2020

Front. Microbiol.

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A recent collection of Lepiota spiculata from the Dominican Republic is presented here. Macro-and micromorphological features of L. spiculata are described in detail, and its evolutionary (phylogenetic) position within Lepiota sect. Ovisporae, in the subincarnata/brunneoincarnata clade, is assessed on the basis of a combined nrLSU + nrITS + rpb2 + tef1 analysis. Additionally, high levels of deadly amatoxins were detected and quantified in L. spiculata for the first time by HPLC analysis; in particular, α-amanitin was found at concentrations up to approximately 4 mg/g dry weight, which render L. spiculata a potentially lethal mushroom, if ingested.

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Phalloides Syndrome Poisoning After Ingestion of Lepiota Mushrooms

Cited by 9 publications

References 5 publications

A Case Study: Rare Lepiota brunneoincarnata Poisoning

A Case Study: Rare Lepiota brunneoincarnata Poisoning

Profiling of Amatoxins and Phallotoxins in the Genus Lepiota by Liquid Chromatography Combined with UV Absorbance and Mass Spectrometry

First Report of a Neotropical Agaric (Lepiota spiculata, Agaricales, Basidiomycota) Containing Lethal α-Amanitin at Toxicologically Relevant Levels

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