Lepiota subincarnata J.E. Lange induced fulminant hepatic failure presenting with pancreatitis.
A 43-year-old woman with a medical history significant only for hepatitis B carrier status presented to an emergency department with generalized weakness, dizziness, nausea, and diarrhea 36 h after eating an estimated 170 g of sautéed Lepiota subincarnata J.E. Lange (basionym Lepiota josserandii). Laboratory evaluation revealed profound metabolic acidosis with mild transaminitis, mild coagulopathy, and renal insufficiency. Marked biochemical evidence of pancreatitis was present prior to significant hepatotoxicity. The patient ultimately required liver transplantation on hospital day 7 and was discharged home on hospital day 12.
Mottram
Allan R
AR
Department of Emergency Medicine, Division of Toxicology, Cook County-Stroger Hospital, Chicago IL, 60612, USA. allan.mottram@gmail.com
Lazio
Matthew P
MP
Bryant
Sean M
SM
D000328:Adult; D000363:Agaricales; D001784:Blood Gas Analysis; D003422:Critical Care; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D009145:Mushroom Poisoning / Q000473:pathology*; D010195:Pancreatitis / Q000139:chemically induced* / Q000473:pathology