Poison Control Center, Angers University Hospital (CHU Angers), Angers, France.
Poison Control Center, Bordeaux University Hospital (CHU Bordeaux), Bordeaux, France.
Basic Clin Pharmacol Toxicol. 2023 Jun;132(6):533-542. doi: 10.1111/bcpt.13858. Epub 2023 Mar 20.
Cyclopeptide mushroom poisoning is responsible for 90%-95% of deaths from macrofungi ingestion. The main objectives of this study are to describe cases of cyclopeptide mushroom poisoning and to determine risk factors that may influence the severity/mortality of poisoned patients. We included all cases of amatoxin toxicity reported to two French Poison Centers from 2013 through 2019. We compared the severity with the Poison Severity Score (PSS) and the outcomes of patients using simple logistic regression and multinomial logistic regression. We included 204 cases of amatoxin toxicity. More than three-quarters developed an increase in AST and/or ALT (78.1%), and over half developed a decrease in prothrombin ratio (<70%: 53%) and/or Factor V (<70%: 54%). One-third developed an acute renal injury (AKI). Twelve patients (5.9%) developed post-poisoning sequelae (persistent kidney injury more than 1 month after ingestion and liver transplant). Five patients (2.5%) received a liver transplant, and nine died (4.4%). The mean time to onset of digestive disorders was shorter in PSS2 and PSS3-4 patients (10.9 ± 3.9/11.3 ± 6.3 h) than in PSS1 patients (14 ± 6.5 h; p < 0.05). Patients who died or developed post-poisoning sequelae had more frequent cardiovascular comorbidities compared with recovered patients (60.0% versus 29.5%; p < 0.01).
环肽蕈中毒是食用大型真菌导致死亡的 90%-95%的原因。本研究的主要目的是描述环肽蕈中毒病例，并确定可能影响中毒患者严重程度/死亡率的危险因素。我们纳入了 2013 年至 2019 年向法国两个中毒中心报告的所有鹅膏肽类毒素中毒病例。我们使用简单逻辑回归和多项逻辑回归比较了患者的严重程度和预后。我们纳入了 204 例鹅膏肽类毒素中毒病例。超过四分之三的患者出现 AST 和/或 ALT 升高（78.1%），超过一半的患者出现凝血酶原比值下降（<70%：53%）和/或因子 V 下降（<70%：54%）。三分之一的患者发生急性肾损伤（AKI）。12 名患者（5.9%）出现中毒后后遗症（摄入后 1 个月以上持续肾损伤和肝移植）。5 名患者（2.5%）接受了肝移植，9 名患者死亡（4.4%）。PSS2 和 PSS3-4 患者发病时间（10.9 ± 3.9/11.3 ± 6.3 小时）比 PSS1 患者（14 ± 6.5 小时）更短（p < 0.05）。与康复患者相比，死亡或出现中毒后后遗症的患者更常伴有心血管合并症（60.0% 与 29.5%；p < 0.01）。
