Abstract
A 43-year-old woman with a medical history significant only for hepatitis B carrier status presented to an emergency department with generalized weakness, dizziness, nausea, and diarrhea 36 h after eating an estimated 170 g of sautéed Lepiota subincarnata J.E. Lange (basionym Lepiota josserandii). Laboratory evaluation revealed profound metabolic acidosis with mild transaminitis, mild coagulopathy, and renal insufficiency. Marked biochemical evidence of pancreatitis was present prior to significant hepatotoxicity. The patient ultimately required liver transplantation on hospital day 7 and was discharged home on hospital day 12.
Keywords: Lepiota josserandii, Lepiota subincarnata J.E. Lange, Mushroom poisoning, Pancreatitis, Liver failure, Mushroom, Hepatotoxic, Transplant
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Acknowledgments
The authors would like to thank Patrick Leacock, PhD, The Field Museum, Chicago, IL; Else C. Vellinga, PhD, Bruns Lab, University of California, Berkeley, CA; and Connie B. Fischbein, BA, Illinois Poison Center for their expert consultations.
Footnotes
Funding sources: There are no funding sources to report.
Prior presentations: This manuscript has not been previously presented. It has been accepted for a poster session at the 2009 North American Congress of Clinical Toxicology.
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