Amatoxins Poisonings in Korea.
- Author:
Byung Min AHN
1
;
Dong Soo LEE
;
Kang Moon LEE
;
Sang Bum KANG
;
Jin Mo YANG
;
Young Min PARK
;
Young Sok LEE
;
Kyu Won CHUNG
;
Hee Sik SUN
;
Doo Ho PARK
;
Hyun Joo RHO
;
Young Mo KANG
;
Jong Myung LEE
;
Jung Wook HUR
;
Sung Gon CHOI
;
Jeong Ho KIM
;
Sang In LEE
;
Seung Ok CHOI
;
Hong Youp CHOI
;
Oh Sun KWON
;
Chang Duck KOO
;
Soon Ja SEOK
;
Yang Sup KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
amatoxins;
mortality;
Amanita virosa;
A. subjunquillea
- MeSH:
Agaricales;
Amanita;
Gangwon-do;
Humans;
Incidence;
Korea*;
Liver Failure;
Male;
Mortality;
Mushroom Poisoning;
North America;
Poisoning*;
Thrombocytopenia
- From:The Korean Journal of Hepatology
2000;6(3):340-349
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: From the review of Korean literature most fatal mushroom poisonings have been due to amatoxins with high mortality. So far there have never been investigations on the amatoxins poisonings such as annual incidence, mortality, common causal species, and endemic areas. This study was carried out to develop some basic statistics as part of studies for an effective management of amatoxins intoxications. METHOD: For the year 1999 authors collected cases of mushroom poisonings which had been mainly gathered from hospitals nation-wide. All of the cases with suggestive amatoxins poisonings were screened by symptomatology and laboratory findings. The causal species of mushrooms were identified grossly and microscopically. RESULTS: A total of 54 victims with mushroom poisonings were evaluated. The causal mushroom toxins were diagnosed or strongly suggested as amatoxins in 43 of 54 victims. Eleven of 54 victims did not conform to the category of amatoxins intoxication due to absent or minimal elevation of aminotransferase. Mean age of the victims was 44.3 23.3 (range: 7-78) with male predominance (1.2 : 1). The causal species were confirmed, or strongly suggested, as Amanita virosa in 25 victims, Amanita subjunquillea in 14, and unknown species in 4. Thirty-five out of a total of 43 were regarded as moderate to severe intoxication (AST or ALT >1,000 IU/L) with 20% mortality. Most fatal victims showed marked thrombocytopenia (40,000 19,000/mm3) compared to non-fatal victims (109,066 42,245/mm3). A total of 88.4% of victims was developed in the Kangwon and Kyungpuk provinces. Both are west of the Taebaek Mountains (38/43). CONCLUSIONS: Although the common causal species for amatoxins poisonings in Korea are different from European countries and North America, the mortality is similar to that of those areas. In order to further reduce the mortality, bedside diagnostic methods using biological fluids and more effective therapy for liver failure should be established.
