MUSHROOMS Cyclopeptide Containing Mushrooms http www inf unitn

MUSHROOMS

Cyclopeptide Containing Mushrooms

http: //www. inf. unitn. it. /~mflorian/ mycology/fungi/amanphal. html

� 95% of mushroom fatalities are due to these �Include A. verna (death angel), A. virosa (destroying angel), A. phalloides (death cap) �Also, Galerina autumnalis, G. marginata, G. Venenata, and Lepiota helveola

Symptoms �Usually not before 6 -12 hours �Include profuse, watery diarrhea, and gastroenteritis at 12 -24 hours; transient improvement � 1 -6 days later; hepatic, renal and at times pancreatic toxicity and death

�Toxin is heat-stable, insoluble in water and loses activity very slowly over years �Mortality related to age and dose (0. 1 mg/kg is lethal) �Children are more susceptible

�Toxicity of alpha-aminitin is through interference with RNA polymerase II, prevents the transcription of DNA �Phalotoxins are rapid-acting and interrupt actin polymerization, impair cell membrane function, has limited absorption.

Therapy �Continuous gastrointestinal charcoal lavage to decontaminate (theoretically, up to five days) �Watch for altered mental status due to hypoglycemia �Supportive therapy

Antidotes �Penicillin displaces amatoxin from plasma protein-binding sites �May inhibit penetration of amatoxin into hepatocytes �Doses of 300, 000 to 1, 000 units benzyl penicillin daily �N-acetylcysteine may be helpful as in any patient with liver injury

Other Antidotes �Thioctic acid (alpha-lipoic acid) �Silibinin (extract of silymarin from Silybum marianum) �Cimetidine may be hepatoprotective. �Consider liver transplantation early (Prior to grade III hepatic encephalopathy)

Monomethylhydrazine Containing Mushrooms

http: //www. wisc. edu/botany/fungi/apr 97

�Associated with mortality of 40% �Include G. californica, G. brunnea, G. esculenta

�Toxicity is due to gyromitrin which is metabolized to monomethylhydrazine �This metabolite reacts with pyridoxine resulting in inhibition of pyridoxal phosphate-related enzymatic reactions

Symptoms �Headache, nausea, vomiting, seizures, and hepatorenal failure �Symptoms occur 6 -10 hours after ingestion �Toxin may be eliminated with cooking but inhalation of cooking fumes may cause poisoning

Therapy �Pyridoxine, in dose of 25 mg/kg

Glutamate Glutamic Acid GABA Pyridoxal 5' phosphate

Muscarine-Containing Mushrooms

http: //www. inf. unitn. it. /~mflorian/ mycology/fungi/clitphae

�No lethality �Includes Clitocybe dealbata (the sweater), C. Illudens (omphalotus olearius) and Inocybe lacera �Small amounts of muscarine are in Amanitia muscaria

�Symptoms: SLUDGE within 0. 5 -2 hours �Therapy: Atropine

Coprine-Containing Mushrooms

�Rarely fatal �Coprinus atramentarius (inky caps) �Coprine has a disulfiramlike effect (Blocks acetaldehyde dehydrogenase) �Requires ingestion of alcohol 48 -72 hours after mushroom

�Symptoms: Flushing, headache, hypotension, histamine induced vasodilation �Therapy: Supportive, anti H 1 and anti H 2, prostaglandin inhibitors

Ibotenic Acid- and Muscimol. Containing Mushrooms

http: //www. inf. unitn. it. /~mflorian/ mycology/fungi/amanpant

�Not lethal �Amanita gemmata, A. muscaria and A. pantherina �Symptoms: Within 0. 5 -2 hours, somnolence, hallucinations and delirium, in adults �Also, myoclonus, seizures and other neurologic effects in children

�Action is due to stimulation of GABA receptors �Therapy: Benzodiazepine

Psilocybin-Containing Mushrooms

http: //www. halcyon. com/ mycomed/gallery 1

�Rare mortality �Symptoms: In 0. 5 -1 hour, CNS effects: ataxia, hyperkinesis, hallucinations, and seizures �Psilocybe cubensis, P. caerulescens, Conocybe cyanopus, Panaeolus foenisecii, Gymnopilus spectabilis, Psathyrella foenisecii

Gastrointestinal Toxins

http: //www. inf. unitn. it. /~mflorian/ mycology/fungi/bolevent

�Death is rare �“Little brown mushrooms” �Boletes, Lactarius, Rhodophyllus, Tricholoma, Chlorophyllum molybidites, C. esculentum

Symptoms �Variable but usually in 0. 5 -3 hours �Nausea, vomiting diarrhea and epigastric distress �Supportive therapy �Resolution of symptoms in 6 -24 hours

Orelline-and Orellanine. Containing Mushrooms

http: //www. inf. unitn. it. /~mflorian/ mycology/fungi/corteleg

�May be lethal �Symptoms: In 24 -36 hours, headache, chills, anorexia, nausea, gastritis �Hepatotoxicity, and oliguric renal failure may develop �Therapy: Supportive

Ralph's Rules �If uncertain of the identity of a species, don't try it

Try to Identify New Species �Draw no conclusions until definitive spore print, cross section of gill, stem and bruise color. �Be able to state with confidence what distinguishes specimen from 3 -5 look alikes

�Confidence of limits of variability of species �Photos confirm identity �Odor, bruising, brittleness, habit, . . . support identification

�Avoid LBM's, amanita, cortinarius �Use recent texts and monographs �Must be worth eating

�Eat slowly: first taste the species. Second taste is more than 24 hours later. �Wait another 24 hours before trying a full-sized serving �Do not over-indulge

�Gather only one species at a time �Do not eat more than one species at a time �Do not eat any species raw