title: A Case Study: Rare Lepiota brunneoincarnata Poisoning.
abstract: Amatoxin poisoning from the genus Lepiota may have a deadly outcome, although this is not seen as often as it is from the genus Amanita. In this report, we present a patient who was poisoned by a sublethal dose of Lepiota brunneoincarnata mushrooms. The patient was hospitalized 12 hours after eating the mushrooms. The patient's transaminase levels increased dramatically starting on day 4. Aspartate transaminase peaked at 78 hours. Starting at 1265 IU/L, alanine transaminase peaked at 90 hours at 5124 IU/L. The patient was discharged on day 8 to outpatient care, and his transaminase levels returned to normal ranges in the subsequent days. A toxin analysis was carried out on the mushrooms that the patient claimed to have eaten. Using reversed-phase high-performance liquid chromatography analysis, an uptake of approximately 19.9 mg of amatoxin from nearly 30 g of mushrooms was calculated. This consisted of 10.59 mg of α-amanitin, 9.18 mg of β-amanitin, and 0.16 mg of γ-amanitin. In conclusion, we present a patient from Turkey who was poisoned by L. brunneoincarnata mushrooms.
authors.affiliation: Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey (Drs Kose and Guler).
authors.forename: Murat
authors.initials: M
authors.lastname: Kose
authors.affiliation: Department of Pharmacology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey (Dr Yilmaz). Electronic address: driyilmaz@yahoo.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Yilmaz
authors.affiliation: Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey (Dr Akata).
authors.forename: Ilgaz
authors.initials: I
authors.lastname: Akata
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Duzce University, Duzce, Turkey (Dr Kaya).
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Kaya
authors.affiliation: Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey (Drs Kose and Guler).
authors.forename: Kerim
authors.initials: K
authors.lastname: Guler
mesh_terms: D000328:Adult; D000363:Agaricales / Q000737:chemistry*; D000410:Alanine Transaminase / Q000378:metabolism; D053959:Alpha-Amanitin / Q000633:toxicity; D000546:Amanitins / Q000633:toxicity*; D001219:Aspartate Aminotransferases / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D009145:Mushroom Poisoning / Q000382:microbiology / Q000628:therapy*; D014421:Turkey
chemical_list: D053959:Alpha-Amanitin; D000546:Amanitins; C049197:beta-amanitin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: HPLC; Lepiota brunneoincarnata; amatoxin; sublethal toxicity