Abstract

POMILIO, Alicia Beatriz; BATTISTA, Stella Maris  and  ALONSO, Angel. Mushroom poisonings: Part 1: late-onset syndromes. Acta bioquím. clín. latinoam. [online]. 2018, vol.52, n.4, pp.459-487. ISSN 0325-2957.

Mushrooms are of nutritional, organoleptic and commercial value, but they also contain toxic substances that give rise to the so-called mushroom poisoning (mycetism), whose medical management requires knowledge of the toxin in order to achieve the appropriate therapy. In this series of three articles, mushroom toxidromes are classified based on the latency period, which is the time elapsed from ingestion to the onset of the symptoms, in late, delayed-, and early-onset intoxications. In this part 1, the following late-onset syndromes are analyzed: (a) Hepatotoxicity or cyclopeptide syndrome due to amatoxins. (b) Nephrotoxicity or Amanita nephrotoxic syndrome. (c) Erythromelalgia (mycetism due to Clitocybe species). (d) Epileptogenic neurotoxicity or gyromitrinic syndrome. (e) Cerebellar syndrome due to Morchella spp. and (f) Late encephalopathic or neurotoxic syndrome due to Hapalopilus rutilans. Late toxicity comprises potentially more severe syndromes, whose symptoms appear between 6 and 24 hours after ingestion. For each syndrome, latency time, symptomatology, toxins, and the mechanism of action (when known) are analyzed, together with the species of macromycetes involved. Sometimes, if necessary, toxicodynamics and methodologies of analysis are displayed. The last section discusses in general mushroom poisoning management, and in detail, the therapy to counteract mycetism due to amatoxins and gyromitrin, which have been the most widely studied of all mushroom poisonings analyzed in this part 1. This information is considered valuable for the knowledge of clinical biochemists, as well as of medical toxicologists, and health staff of emergency units.

Keywords : Mycetism; Classification; Latency period; Toxidromes; Late-onset syndromes; Toxins; Action mechanisms; Treatments.

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