Ergot Alkaloids are Also Mushroom Poisons

To the interesting and comprehensive review by Wennig et al. (1), it may be added that ergot alkaloids (such as ergotamine) (2) can also be included among the mushroom poisons. The ergot (Claviceps purpurea) actually belongs to the large mushrooms, because small but easily recognizable fruiting bodies grow out of the so-called sclerotium (the permanent form of some sac fungi) in the spring. However, intoxications from ergot (via grain) are more likely to be subsumed in the group of mycotoxins (mold poisoning). Ergot poisoning is not a result of normal mushroom picking. Nowadays, poisoning with ergot alkaloids from grain rarely occurs due to modern agriculture; rather, it occurs through the intake of certain medications, for example against migraines or Parkinson‘s disease, and in obstetrics (3). Interestingly, LSD (lysergic acid diethylamide) is a chemical derivative of lysergic acid from ergot.

Symptomatic poisoning with ergotamine can clinically lead to sometimes massive constrictions of blood vessels with subsequent circulatory disorders of the heart muscle, kidneys, and extremities. People with the latter often appear cold and pale, with a barely detectable pulse. In addition, paresthesia, hypoesthesia, and sometimes paresis can occur. Secondary Raynaud’s syndrome leading up to painful loss of fingers and toes is common (gangrene and necrosis in Ergotismus gangraenosus, the so-called “ergot burn”, also named with Ignis sacer [“holy fire“] or “St. Anthony’s Fire”). In addition, there are often general symptoms, such as vomiting, confusion, and/or diarrhea. Acute poisoning can even lead to death through respiratory or cardiac arrest; chronic poisoning can lead to the loss of limbs with insufficient blood supply. Therapeutically, the triggering drugs should be discontinued immediately and, if necessary, drugs that can cause vascular dilation (e.g. calcium channel blockers, nitrates, or prostaglandins) should be administered.