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Hemolysis associated with Russula subnigricans ingestion in a patient with glucose-6-phosphate dehydrogenase
Yuting Pu1, Feichi Wang1, Hongliang Zhang1
1Department of Emergency Medicine, The Second Xiangya Hospital of Central South University, Emergency and Difficult Diseases Institute of Central South University, Changsha, Hunan, P. R. China.
Introduction:
Russula subnigricans is now one of the leading lethal mushroom species in China, with a mortality rate of more than 50%. The typical clinical manifestation of Russula subnigricans poisoning is rhabdomyolysis, and we are unaware of previous reports of Russula subnigricans-associated hemolysis.
Case Series:
Herein we report a cluster of five patients with confirmed Russula subnigricans poisoning. Four of the patients who ingested sun-dried Russula subnigricans never developed rhabdomyolysis. However, in one patient, acute hemolysis developed on the second day following ingestion and was associated with a fall in hemoglobin concentration and a rise in unconjugated bilirubin concentration. Further investigation revealed that the patient had glucose-6-phosphate dehydrogenase deficiency.
Conclusion:
This case cluster suggests that the toxin of Russula subnigricans could cause hemolysis in a susceptible patient and warrants further study.
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