A Case Study: Rare Lepiota brunneoincarnata Poisoning

Area of Science:

• Mycology
• Toxicology
• Internal Medicine

Background:

• Amatoxin poisoning, primarily associated with Amanita mushrooms, can lead to severe liver damage.
• The genus Lepiota also contains toxic species capable of causing amatoxin poisoning, though less commonly reported.
• This report focuses on a case of Lepiota brunneoincarnata mushroom poisoning.

Observation:

• A patient ingested Lepiota brunneoincarnata mushrooms and presented with delayed, severe elevations in liver transaminases (AST and ALT).
• Hospitalization occurred 12 hours post-ingestion, with peak transaminase levels observed around 78-90 hours.
• The patient showed a favorable clinical course, with transaminase levels normalizing within days after discharge.

Findings:

• Toxin analysis of the consumed mushrooms confirmed the presence of amatoxins, including α-amanitin, β-amanitin, and γ-amanitin.
• Quantification indicated an estimated intake of approximately 19.9 mg of total amatoxins from about 30 g of mushrooms.
• The specific amatoxin composition was detailed, with α-amanitin and β-amanitin being the most abundant.

Implications:

• This case underscores the potential lethality of amatoxin poisoning from Lepiota species.
• It highlights the importance of accurate mushroom identification and prompt medical evaluation in suspected poisoning cases.
• The findings contribute to the understanding of Lepiota-induced toxicity and amatoxin pharmacokinetics in humans.