MANAGEMENT OF SUSPECTED MUSHROOM POISONING

Intoxication with Amanitin has been reported to be lethal in up to 25% of all cases and the mortality rate in children under 10 years of age is above 50%. Therefore, this intoxication should be ruled out in all patients presenting gastrointestinal symptoms after a mushroom ingestion. Amanitin analysis in urine is a valuable diagnostic tool and does significantly contribute to the management of mushroom poisoning.

Mushroom toxicity is a worldwide concern. Mushroom picking is a popular occupation in mushroom season in many countries. Moreover, the increased use of mushrooms as components of organic diets and for alternative therapies in part, accounts for the renewed interest in mycetism. Ingestion by unsupervised children also accounts for a significant percentage of mushroom poisoning incidents.

Most mushroom ingestion does not cause a clinically significant toxidrome. The lethality of a few mushrooms underlines the importance of the Amanitin ELISA offered by BÜHLMANN.

The main toxic actions are caused by Amanitins, which are bicyclic octapeptides. Amanitins occur in the extremely poisonous toadstools such as Amanita phalloides (death cap), Amanita verna (white death cap), Amanita virosa (destroying angel) and other Amanita species. These mushrooms are responsible for the most severe cases of mushroom poisoning with a very high mortality rate. The Amanitin phalloides syndrome is estimated to be responsible for 95% of fatal cases of mushroom poisonings throughout the world. Therefore, this intoxication should be ruled out in all patients presenting with gastrointestinal symptoms after mushroom ingestion.
Amatoxins are detected in urine samples within 6 to 60 hours after ingestion i.e. the time by which clinical symptoms occur. The detection of alpha-Amanitin (100 %) and gamma-Amanitin (90 %) in urine using the BÜHLMANN Amanitin ELISA confirms Amanita intoxication.

AMANITIN Product Information

Method ELISA
Time to Result 1 h
Sample Type 40 µl urine, serum, plasma (1:25)
Standard Range 1.0-100 ng/ml
Sensitivity 0.2 ng/ml
Order Code EK-AM1 96 wells
CE

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EK-AM1

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