Cyclopeptide mushroom poisoning: A retrospective series of 204 patients.

Abstract

Cyclopeptide mushroom poisoning is responsible for 90%-95% of deaths from macrofungi ingestion. The main objectives of this study are to describe cases of cyclopeptide mushroom poisoning and to determine risk factors that may influence the severity/mortality of poisoned patients. We included all cases of amatoxin toxicity reported to two French Poison Centers from 2013 through 2019. We compared the severity with the Poison Severity Score (PSS) and the outcomes of patients using simple logistic regression and multinomial logistic regression. We included 204 cases of amatoxin toxicity. More than three-quarters developed an increase in AST and/or ALT (78.1%), and over half developed a decrease in prothrombin ratio (<70%: 53%) and/or Factor V (<70%: 54%). One-third developed an acute renal injury (AKI). Twelve patients (5.9%) developed post-poisoning sequelae (persistent kidney injury more than 1 month after ingestion and liver transplant). Five patients (2.5%) received a liver transplant, and nine died (4.4%). The mean time to onset of digestive disorders was shorter in PSS2 and PSS3-4 patients (10.9 ± 3.9/11.3 ± 6.3 h) than in PSS1 patients (14 ± 6.5 h; p < 0.05). Patients who died or developed post-poisoning sequelae had more frequent cardiovascular comorbidities compared with recovered patients (60.0% versus 29.5%; p < 0.01).

• Authors: Jérémy Lecot, Morgane Cellier, Arnaud Courtois, Dominique Vodovar, Gaël Le Roux, Anne Landreau, Magali Labadie, Chloé Bruneau, Alexis Descatha
• Journal: Basic & clinical pharmacology & toxicology (Basic Clin Pharmacol Toxicol) Vol. 132 Issue 6 Pg. 533-542 (Jun 2023) ISSN: 1742-7843 [Electronic] England
• PMID: 36908014 (Publication Type: Journal Article)
• Copyright: © 2023 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). Published by John Wiley & Sons Ltd.

Chemical References

• Peptides, Cyclic
• Poisons

Topics

• Humans
• Mushroom Poisoning (complications, diagnosis, epidemiology)
• Peptides, Cyclic
• Retrospective Studies
• Liver Failure, Acute
• Disease Progression
• Poisons