title: A case of reversible encephalopathy accompanied by demyelination occurring after ingestion of Sugihiratake mushrooms.
abstract: Recently, an outbreak of acute encephalopathy associated with Sugihiratake mushroom ingestion has been reported in northern Japan. Patients with chronic kidney diseases are thought to be at risk for severe encephalopathy following Sugihiratake mushroom ingestion. We report a case of encephalopathy associated with Sugihiratake mushroom ingestion in a patient with diabetic nephropathy. Brain magnetic resonance imaging showed discriminative intensity in the medial temporal lobe, claustrum, and insula cortex bilaterally. Cerebrospinal fluid examination revealed mildly elevated protein and marked elevation of myelin basic protein without pleocytosis. Twenty-five days after admission, these signal-intensity changes had markedly improved, and the patient was discharged without sequelae. Although the exact mechanism of this acute encephalopathy remains undetermined, demyelination is believed to be a possible associated pathological change. In cases of encephalopathy of undetermined cause with distinct magnetic resonance findings, Sugihiratake mushroom intoxication should be considered in areas where ingestion of this mushroom is common.
authors.affiliation: Department of Neurology, Kitamurayama Public Hospital, Yamagata, Higashine-shi, Yamagata, Japan. nomotatsu@jichi.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nomoto
authors.forename: Takehiro
authors.initials: T
authors.lastname: Seta
authors.forename: Koichi
authors.initials: K
authors.lastname: Nomura
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Shikama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Katagiri
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Katsura
authors.forename: Takeo
authors.initials: T
authors.lastname: Kato
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000368:Aged; D001927:Brain Diseases / Q000209:etiology*; D003711:Demyelinating Diseases / Q000209:etiology*; D003928:Diabetic Nephropathies / Q000150:complications; D005260:Female; D006801:Humans; D009145:Mushroom Poisoning / Q000150:complications*