Citation

Lecot J, Cellier M, Courtois A, Vodovar D, Le Roux G, Landreau A, Labadie M, Bruneau C, Descatha A. Basic Clin. Pharmacol. Toxicol. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.13858

PMID

36908014

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 one month after ingestion and liver transplant). Five patients (2.5%) received a liver transplant and 9 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 hours) than in PSS1 patients (14±6.5 hours; p<0.05). Patients who died or developed post-poisoning sequelae had more frequently cardiovascular comorbidities compared with recovered patients (60.0% versus 29.5%; p<0.01).

Language: en

Keywords

acute liver failure; Amanita phalloides poisoning; Amatoxins; cyclopeptide mushroom; Mushroom poisoning; Poison control centers; severity factor