Acute liver failure caused by mushroom poisoning: a case report and review of the literature

Abdulsamet Erden,¹ Kübra Esmeray,¹ Hatice Karagöz,¹ Samet Karahan,¹ Hasan Hüseyin Gümüsçü,¹ Mustafa Basak,¹ Ali Çetinkaya,¹ Deniz Avci,¹ Orhan Kürsat Poyrazoğlu<sup>2

1</sup>Internal Medicine Department, ²Gastroenterology Department, Kayseri Training and Research Hospital, Kayseri, Turkey

Abstract: It is estimated that there are over 5,000 species of mushrooms worldwide. Some of them are edible and some are poisonous due to containing significant toxins. In more than 95% of mushroom toxicity cases, poisoning occurs as a result of misidentification of the mushroom by an amateur mushroom hunter. The severity of mushroom poisoning may vary, depending on the geographic location where the mushroom is grown, growth conditions, the amount of toxin delivered, and the genetic characteristics of the mushroom. Amanita phalloides is the most common and fatal cause of mushroom poisoning. This mushroom contains amanitins, which are powerful hepatotoxins that inhibit RNA polymerase II in liver. Mushroom poisoning is a relatively rare cause of acute liver failure. A 63-year-old male patient was admitted to the emergency room with weakness, nausea, vomiting, and diarrhea. He reported ingesting several wild mushrooms about 36 hours earlier. In this article we report a case of lethal Amanita phalloides intoxication from stored mushrooms.

Keywords: acute liver failure, Amanita phalloides, mushroom, poisoning