Winkelmann M, Stangel W, Schedel I, Grabensee B
Klin Wochenschr. 1986 Oct 1;64(19):935-8. doi: 10.1007/BF01728620.
It has been shown that fatal "poisoning" with the mushroom species Paxillus involutus is caused by antibodies against the fungus in sensitized patients. Because circulating immune complexes play an important role, therapeutic procedures which can eliminate those complexes could stop immune hemolysis. A 37-year-old patient became severely ill after repeated ingestion of sufficiently cooked Paxillus involutus. As a result of hemolysis with reversible shock symptoms, acute renal failure developed. Plasma exchange with 3,000 ml albumin 5% was carried out daily during the first 3 days after admission. Each plasma exchange lowered free hemoglobin and immune complex levels by 60%-75%. Acute renal failure was successfully treated with hemodialysis. Specific IgG-antibodies against membrane particles of Paxillus involutus were detected by hemagglutination tests in the serum of the patient. The sequence of reactions resulting from the testing procedures strongly suggests the formation of immune complexes. These complexes are likely to bind to erythrocytes acting as innocent bystanders. Activation of the complement system finally results in hemolysis and shock. In addition to adequate shock treatment elimination of these immune complexes by plasma separation seems to be the therapy of choice.
业已表明，食用卷边桩菇这种蘑菇导致的致命“中毒”是由致敏患者体内针对该真菌的抗体引起的。由于循环免疫复合物起着重要作用，能够清除这些复合物的治疗程序可能会阻止免疫性溶血。一名37岁的患者在多次食用充分煮熟的卷边桩菇后病情严重。由于溶血并伴有可逆性休克症状，继而发展为急性肾衰竭。入院后的头3天，每天进行3000毫升5%白蛋白的血浆置换。每次血浆置换可使游离血红蛋白和免疫复合物水平降低60% - 75%。急性肾衰竭通过血液透析成功治愈。通过血凝试验在患者血清中检测到了针对卷边桩菇膜颗粒的特异性IgG抗体。检测程序所引发的一系列反应强烈提示了免疫复合物的形成。这些复合物可能会与作为无辜旁观者的红细胞结合。补体系统的激活最终导致溶血和休克。除了进行充分的休克治疗外，通过血浆分离清除这些免疫复合物似乎是首选的治疗方法。
