Lake Zachary, Ludwik Tasia, Hake Caylie
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, United States.
Front Vet Sci. 2025 Jun 18;12:1542020. doi: 10.3389/fvets.2025.1542020. eCollection 2025.
A 12-week-old, male intact, Shetland Sheepdog presented with acute onset vomiting and diarrhea, rapidly progressing to stupor and hypoglycemic shock following ingestion of α-amanitin-containing mushrooms. Despite aggressive therapeutic interventions, the patient exhibited rapid systemic deterioration characterized by recurrent hypoglycemia, hypotension, and multi-organ failure, leading to cardiopulmonary arrest within 22 h of presentation. Definitive diagnosis was unable to be elucidated prior to death, leading to an untailored treatment plan. Post-mortem analysis confirmed extensive necrosis of the liver, kidneys, and brain. Presence of α-amanitin was confirmed in the hepatic tissue via post-mortem liquid chromatography-tandem mass spectrometry analysis. Serum collected at presentation was submitted post-mortem for an insulin level which was found to be discordantly elevated, which may demonstrate an alternative mechanism of hypoglycemia in this case. This case highlights the rapidly lethal potential of α-amanitin in pediatric patients and the non-classical case presentation. This report contributes to the limited veterinary literature on this toxin in pediatric patients and underscores the need for heightened awareness and rapid diagnosis and treatment in suspected cases.
一只12周大的未绝育雄性设得兰牧羊犬，在摄入含α-鹅膏毒素的蘑菇后，出现急性呕吐和腹泻，迅速发展为昏迷和低血糖休克。尽管采取了积极的治疗措施，但该患者仍表现出迅速的全身恶化，特征为反复低血糖、低血压和多器官功能衰竭，在就诊后22小时内导致心肺骤停。在死亡前未能明确确诊，导致治疗方案缺乏针对性。尸检分析证实肝脏、肾脏和大脑广泛坏死。通过尸检液相色谱-串联质谱分析，在肝组织中确认存在α-鹅膏毒素。就诊时采集的血清在尸检时送检胰岛素水平，发现其异常升高，这可能表明该病例中低血糖的另一种机制。本病例突出了α-鹅膏毒素对儿科患者的快速致死潜力以及非典型病例表现。本报告为关于这种毒素在儿科患者中的有限兽医文献做出了贡献，并强调在疑似病例中需要提高认识以及快速诊断和治疗。
