Gyromitra mushrooms: Difference between revisions
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==Clinical findings== | ==Clinical findings== | ||
*GI upset, fatigue, muscle cramps | *GI upset, fatigue, muscle cramps | ||
*Liver failure | |||
*Hypoglycemia | |||
*Can present with refractory seizures due to GABA deficiency | *Can present with refractory seizures due to GABA deficiency | ||
*Hemolysis usually mild | *Hemolysis usually mild | ||
*Rarely methemoglobinemia | *Rarely methemoglobinemia | ||
==Workup<ref>Tomková J, Ondra P, Válka I. Simultaneous determination of mushroom toxins α-amanitin, β-amanitin and muscarine in human urine by solid-phase extraction and ultra-high-performance liquid chromatography coupled with ultra-high-resolution TOF mass spectrometry. Forensic Sci Int. 2015 Jun. 251:209-13.</ref>== | |||
*Blood sugar | |||
*BMP | |||
*LFT | |||
*Coags | |||
*CBC with differential | |||
*LDH, haptoglobin, reticulocyte | |||
*CK | |||
*MetHb level | |||
*Urine drug screen | |||
*Urinalysis | |||
==Management== | ==Management== | ||
Revision as of 15:13, 11 May 2016
Overview
- Also known as "brain fungi"
- Fruit in the spring and early summer
- Frequently mistaken for morel mushrooms[1]
- Inhibits formation of Vitamin B6 and GABA via hydrazine metabolite
Clinical findings
- GI upset, fatigue, muscle cramps
- Liver failure
- Hypoglycemia
- Can present with refractory seizures due to GABA deficiency
- Hemolysis usually mild
- Rarely methemoglobinemia
Workup[2]
- Blood sugar
- BMP
- LFT
- Coags
- CBC with differential
- LDH, haptoglobin, reticulocyte
- CK
- MetHb level
- Urine drug screen
- Urinalysis
Management
- Supportive care
- High dose pyridoxine for refractory seizures (5g IV initially)
- Avoid phenobarbital, especially in liver failure
- Methylene blue for severe methemoglobinemia
- Folinic acid supplementation (hydrazines inhibit MTHF production)
See Also
References
- ↑ Brozen R et al. Gyromitra Mushroom Toxicity. Apr 14, 2015. http://emedicine.medscape.com/article/817931-treatment#showall.
- ↑ Tomková J, Ondra P, Válka I. Simultaneous determination of mushroom toxins α-amanitin, β-amanitin and muscarine in human urine by solid-phase extraction and ultra-high-performance liquid chromatography coupled with ultra-high-resolution TOF mass spectrometry. Forensic Sci Int. 2015 Jun. 251:209-13.