Vergiftungen durch den Kahlen Krempling (Paxillus involutus), eine genie\bare Pilzart

Bschor, F; Mallach, H. J.

doi:10.1007/bf00577560

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…Furthermore, although several persons may have consumed of the same meal, only one person is affected. This is in contrast to the condition which mainly involves gastric side-effects, caused by the same mushrooms [6][7][8][9]13]. Manifestations of acute haemolysis include DIC, severe back and abdominal pain, gastrointestinal symptoms, lactic acidosis and progressive multiorgan failure, predominantly affecting the liver and kidneys.…”

Section: Discussionmentioning

confidence: 92%

“…In summary, a quick differential diagnosis can be made by a long history of consuming the mushroom by the patient, the rapid onset of symptoms [6], the sudden rise in bilirubin and the absence of symptoms in co-consumers. Pre-existing liver and kidney damage may exacerbate the condition.…”

Section: Discussionmentioning

confidence: 99%

“…Additional to gastrointestinal Intoxications with brown roll-rim may present as one of two poisoning events, the first of which characteristically involves mainly gastrointestinal effects. This typically occurs after consuming the raw or insufficiently cooked mushroom, although similar reactions have occurred after proper heating [6]. Finally, usually all persons who consumed the mushrooms present with symptoms of this kind.…”

Section: Introductionmentioning

confidence: 99%

“…Paxillus involutus, commonly known as poison pax or brown roll-rim, has been widely consumed in earlier years. Meanwhile, following a number of fatal intoxications, the fungus is officially classified as dangerously poisonous [6][7][8][9]. Nevertheless, it is still considered edible by some mycophagists.…”

Section: Introductionmentioning

confidence: 99%

“…Reports of the Paxillus syndrome are however rare. Our literature search for publications in the English and German languages resulted in merely fourteen cases of AIHA and hepatotoxicity associated with poison pax [4,[6][7][8][9][11][12][13]. Six of these cases ended fatally [4,6,13].…”

Section: Introductionmentioning

confidence: 99%

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Fatal Immunohaemolysis after the Consumption of the Poison Pax Mushroom: A Focus on the Diagnosis of the Paxillus Syndrome with the Aid of Two Case Reports

Stöver¹,

Haberl

Helmreich³

et al. 2019

Diagnostics

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This retrospective report focuses on the diagnosis of the Paxillus syndrome, based on two fatal cases of haemolysis following the consumption of Paxillus involutus. These mushrooms are still consumed regularly, despite earlier reports of life-threatening autoimmune haemolytic anaemia. Such cases are nevertheless rare, and thus far no toxin could be identified that causes this unusual form of mushroom poisoning. All these factors contribute to the difficulty in diagnosing the Paxillus syndrome. The following aspects support the diagnosis in the two cases presented here: Both patients consumed the mushroom oftentimes before, yet allegedly without ill effects. Symptoms occurred 2–3 h after the last consumption, exacerbating into circulatory collapse, multiorgan failure, and death. Disseminated intravascular coagulation was identified as cause of death by autopsy of patient 1. Patient 2 died of multiorgan failure, mainly hepatic. Our mycological analyses could identify the consumed mushroom in both cases as Paxillus involutus. Furthermore, we could exclude anticoagulants and several other drugs as trigger for the haemolysis by post-mortem toxicological analysis. However, findings in each of the two cases may have led to the haemolysis, independent of the consumption of Paxillus involutus. Patient 1 carried the anti-erythrocytic antibody, auto-anti-e. Patient 2 contracted chronic hepatitis C years prior to the current incident. Considering the rarity of the Paxillus syndrome, our findings suggest that these patients were particularly susceptible for haemolysis after consuming this mushroom over a prolonged period. Occurrence of the Paxillus syndrome may thus be restricted to regular consumers of Paxillus involutus mushrooms with an existing predisposition for haemolysis.

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