Amanitin Toxicosis

Amanitin Toxicosis



Basic Information image



Definition


Acute hepatotoxicity subsequent to amanitin-containing mushroom exposure



Synonym(s)




• Amanita toxicosis


• Death cap intoxication


• Amatoxin poisoning


• Hepatotoxic mushroom poisoning


• Amanitin poisoning



Epidemiology



Geography and Seasonality


Amanita phalloides mushrooms are found throughout North America, commonly in association with oaks and birch. The large fruiting bodies appear in the summer and fall. Local mycologic societies can provide detailed information on the occurrence of toxic mushrooms in certain regions.



Clinical Presentation



Disease Forms/Subtypes




• Severe gastrointestinal (GI) signs such as colic and diarrhea


• Acute hepatotoxicosis


• Fulminant multiorgan failure



History, Chief Complaint




• Colic and diarrhea within 24 hours of amanitin-containing mushroom exposure


• Lethargy, icterus, ataxia, seizures, and coma approximately 36 to 48 hours after exposure to amanitins



Physical Exam Findings




• The clinical course of amanitin exposure can be divided into four phases. Physical examination findings are different for each phase.


• The initial phase is a latency period of approximately 8 to 12 hours without any clinical signs after ingestion of amanitin-containing mushrooms.

• During the second phase (6 to 24 hours after mushroom ingestion), the animal develops severe GI signs such as colic and diarrhea.

• The third phase is a period of several hours to a few days during which the animal appears to have recovered. During this phase, close monitoring of liver and kidney function is essential to prevent misdiagnosis.

• The final stage begins approximately 36 to 84 hours after exposure to amanitins. In this stage, fulminant liver, renal, and multiorgan failure may occur, and affected animals may be icteric, lethargic, and ataxic and have seizures or coma. If large amounts of amanitin-containing mushrooms were ingested, it is feasible that the animal will die acutely within 24 hours and may simply be found dead.


Etiology and Pathophysiology




• Amanitins (α-, β-, γ-, and ε-amanitins) are bicyclic octapeptides and are found in three different mushroom genera: Amanita, Galerina, and Lepiota spp.


• The most toxic cylopeptide-containing mushrooms are A. phalloides, the ubiquitous “death cap” or “death angel,” and Galerina sulpices. A. phalloides is found throughout North America, commonly in association with oaks and birch. G. sulpices is most commonly found in Europe.


• Amanitins inhibit nuclear RNA polymerase II, ultimately leading to decreased protein synthesis and cell death.


• Cells with a high metabolic rate, such as hepatocytes, crypt cells, and proximal convoluted tubules of the kidneys, are most commonly affected.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Amanitin Toxicosis

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