Med Clin (Barc). Apr 30;84(16) [Amanita phalloides poisoning. Diagnosis by radioimmunoassay and treatment with forced diuresis]. [Article in. La rareza, gravedad de los síntomas y su semejanza con las intoxicaciones por Amanita phalloides nos ha parecido interesante para su. Hongos venenosos; una revisión de las intoxicaciones más comunes in species of Amanita genus such as: Amanita phalloides, A. virosa, A. verna, A. ocreata.

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Poisonous mushrooms; a review of the most common intoxications. Lima 1R. Costa Fortes 2M. Garbi Novaes 3 and S. Mushrooms have been used as components of human diet and many ancient documents written in oriental countries have already described the medicinal properties of fungal species.

[Poisoning by mushrooms of the Amanita phalloides type].

Some mushrooms are known because of their nutritional and therapeutical properties and all over the world some species are known because of their toxicity that causes fatal accidents every year mainly due to misidentification.

Many different amanuta belonging to poisonous mushrooms were already identified and are related with different symptoms and signs. Carcinogenicity, alterations in respiratory and cardiac rates, renal failure, rhabidomyolisis and other effects were observed in toxicity studies with various species including edible and therapeutic ones. Proper identification is important to avoid accidents and toxicity studies are necessary to assure the safe use of mushrooms as food and for medicinal purposes.

Apart from mushrooms that contain psychoactive toxins, ingestion of toxic mushrooms is invariably accidental and caused by misidentification of species. There are some mushrooms that contain exceptionally powerful toxins that represent a real hazard to intoxiccacion even when ingested in small doses. Ontoxicacion toxins were well studied and are described in literature, such as amatoxins that are cytotoxic and cause harm to kidney and liver and orellanine that is nephrotoxic.

Some species are well utilized for food and medicine due to the presence of pharmacologically active substances and essential nutrients. Because of these properties, mushrooms were described as popular remedies in ancient oriental documents and some of them became ingredients in traditional medicine.

Before using species of mushroom for human consumption it is necessary to characterize their toxicological profile because even in some edible species toxic amxnita have been identified. The toxicity studies consist of exposing species of mammal to a toxic agent during a specific wmanita of time.

Some species of mushrooms are known as toxic and in some countries many cases of mushroom poisoning are reported every year. In the year in France 1, cases of intoxications by mushrooms were reported and in this country alone it is estimated that Most of these accidents are due to incorrect identification of species that is often made by empirical and traditional knowledge.

The family Amanitaceae genus Amanita is well known as having many toxic species. Amatoxins are present in species of Amanita genus such as: The family of amatoxin comprises a neutral component designated as alpha-amanitin, an acid one called betaamanitin, gamma and delta-amanitin and the nonpoisonous component amanullin from A.

Inntoxicacion toxins also found in Amanita genus belong to the family of phallotoxin that includes phalloin, phalloidin, phallisin, phallacidin, phallacin and phallisacin. Virotoxin is also found in this genus and are closed related the phallotoxins.

The toxic effects are caused by phallotoxin and amatoxin. Phallotoxin causes alterations of enterocytes cellular membrane, while amatoxin inhibits protein synthesis at a transcriptional level within enterocytes, hepatocytes and proximal renal tubular cells. After ingestion of A. Only a minority of patients need emergency liver transplantation.

Species with hallucinogenic effects are also found in amanita genus. Two dissociative constituents such as ibotenic acid IBO and muscimol MUS are responsible for the hallucinogenic effects. The pantherina-muscaria syndrome is atropine-like and in the number and severity of poisoning cases fatality is rare.


In most cases recovery is complete after 24 hours. The treatment is mainly symptomatic cholinestarase inhibitors may be recommended as it counteracts the effects of poisoning, benzodiazepinics or phenobarbitone can be used in case of seizures. A particular syndrome that affected five people in the region of Savoie in France was later identified as intoxication caused by the mushroom Clitocybe amoenolens.

First symptoms appeared 24 hours after ingestion. Patients presented paresthesia of the toes and fingers followed by paroxysmal burning pain lasting hours, notably at night. A sensation of heat, numbness, oedema and local erythema are associated with crises. Symptoms are partially relieved with cold water, acetylsalicylic acid, morphine and clomipramine. Recovery is completely after months. The administration of high dose of C.

[Amanita phalloides poisoning. Diagnosis by radioimmunoassay and treatment with forced diuresis].

Examination of the sciatic nerves showed decreased axon density and neuronal fiber degeneration. The poisonous specie C.

The substances pointed out as responsible for the symptoms are the acromelic acids A-E. Acromelic acid ACRO is a kainate analogue that is assumed to be involved in poisoning episodes.

ACRO-A was demonstrated to have a powerful excitatory action on mechanosensitive unmyelinated afferents in skeletal muscle of the rat. Species of genus Clitocybe also cause muscarinic syndrome. Approximately 15 minutes to 2 hours after ingestion patient can present gastrointestinal problems, miosis, hypersecretion and in severe cases bradycardia and collapses. The treatment of this syndrome is symptomatic and atropine can be administered to counteract the effects of muscarine.

There are approximately 40 species belonging do Inocybe genus in China, and they are known to be not edible. They produce neurotoxic and psychotropic effects due to the presence of biogenic amines, muscarin, pro a thymethylammonium analogue of psylocibin which effects phalolides be discussed later in this article.

The genus Cortinarius comprises between 2, species of mushrooms that were considered as non-toxic until One hundred-and-thirty-five cases of intoxication caused by C. Poisoning syndrome is characterized by a delayed acute tubulopathy that can progress to chronic renal insufficiency.

In several case reports it was demonstrated that the mushrooms C.

In additional studies it was shown that the oxidation of orellanine in renal tissue may accumulate quinone compounds which bind covalently with biological structures leading to cell damage. The symptoms of orellanine intoxication may appear between days after ingestion. Initially people can experience nausea, vomiting and abdominal pain. This is followed by intense thirst, chills, polyuria or oliguria and possibly anuria.

Hemodialysis may be necessary until renal function gradually improves.

Some species of genus Cortinarius can be confused with members of Psilocybe genus which is known as magic because the hallucinogenic properties. This fact intoxicacioh led to several cases of accidental intoxication because Psilocybe mushrooms are used for some people for recreational purposes.

Species of genus Gyromitrafamily Helvellaceae are really attractive to hunters and gourmets because of their taste. Porr, some species of Gyromitra contain a well known toxin named gyromitrin, whereas other species are non-toxic. This is one of the reasons why intoxications occur, toxic and non-toxic species are sometimes difficult to distinguish because they are mixed-up.

The other reason is that the toxin is water soluble and volatile, boiling for long time and drying allows ingestion amankta risk of poisoning, but if these procedures are not done properly intoxication may occur. The third reason for intoxication pod the confusion with species that are consumed frequently. The toxin gyromitrin is the responsible for the effects of this specie.

Intoxications have occurred not only by eating fresh false morels but also by the inhalation of vapors from cooking. Intoxications caused by G. Most common symptoms are gastrointestinal vomiting and diarrhea and neurological vertigo, fatigue, tremor, ataxia, nystagmus. A few patients have developed mild to moderate liver damage and haemolysis.


After ingestion gyromitrin is hydrolysed in stomach forming hydrazines that are cytotoxic, convulsants and irritating to mucous membranes. The other effect of gyromitrin include carcinogenesis due to the hepatic metabolization that produces free radicals with mutagenic properties in animals and are also responsible for the hepatic problems.

Symptoms of intoxication start hours after ingestion. Treatment consists of monitoring the symptoms and administrating vitamin B6 intravenously considering that gyromitrin inactivates this vitamin. The use of psychoactive substances of fungal origin for recreational purposes has become an increasing problem in many countries all over the world.

Species of genus Psilocybe are known due to their psychedelic effects caused by psilocybin. The symptoms of intoxication occur 30 minutes after ingestion of fresh or dried mushroom and start with anxiety, nausea, vertigo and asthenia, neurosensorial intoixcacion consists of visual problems, disorientation, motor incoordination and sympathomimetic symptoms consist of phalloidew, tachycardia and hypertension.

Recovery is completely 4 to 12 hours after ingestion. The need of hospitalization is rare and in exceptional cases myocardial infarction may occur in adult patients while children may present hyperthermia, seizures and comma. Some species known as edible and medicinal also have substances that can cause harm to health, but the dose and magnitude of effects on humans must be carefully studied.

Ostreolysin is a cytolytic protein that was isolated from mushrooms of the genus Pleurotus that was able to cause cytolytic pore formation when administered by intravenous route to rats. As a consequence it was inhoxicacion blood pressure increase, cardiac ischemia, tachycardia, hypoxia and elevated serum potassium.

The prostate is known to be regulated by various growth factors. Among them the TGFs have been reported to play important role in prostate cell growth regulation.

The administration of P. Agaricus bisporus is the most consumed mushroom world-wide but is has been pointed out as potentially carcinogenic due to the substantial amounts of aromatic hydrazines, an established class of direct-acting chemical carcinogens. Life-time administration of A.

The administration of the methanolic and aqueous extracts of this same mushroom is weakly mutagenic.

[Amanita phalloides poisoning. Diagnosis by radioimmunoassay and treatment with forced diuresis].

The ethanolic extract of this mushroom is increased in the presece of fungal mammalian enzyme systems purified mushroom tyrosinase and rat hepatic citosol.

The specie Pleucybella porrigens popularly known as Sugihiratake is a white mushroom widely intoxicacoon in the mountain areas of Japan and is commonly used as ingredient to various processed foods, but this was pointed out as hazardous due to the presence of substances analogous to vitamin D that are able to cause cryptogenic encephalopathy in patients with renal failure.

The acute toxicity of Agaricus silvaticus was evaluated by administering the aqueous extract of this mushroom in the dose of 1. It was observed that not only the administration of A.

Biochemical and hystopathological were not statistically significant among the groups. The administration of the A. Species of genus Tricholoma especially T.

[Poisoning by mushrooms of the Amanita phalloides type].

The symptoms were muscular weakness, fatigue and myalgias within intoxucacion after ingestion. The substance responsible for toxic effects was not identified. Toxicity is observed after a consumption of considerable amounts of fresh mushroom which ranges from to g at 3 to 9 consecutive meals.