Korean J Hepatol.
2000 Sep;6(3):340-349.
Amatoxins Poisonings in Korea
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea.
- 2Department of Internal Medicine, College of Medicine, Kyungpook University, Taegu, Korea.
- 3Department of Internal Medicine, College of Medicine, Keimyung University, Taegu, Korea.
- 4Kwon Hospital, Yechon, Korea.
- 5Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
- 6Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
- 7Department of Internal Medicine, College of Medicine, Pochon Cha University, Pochon, Korea.
- 8School of Forest Resources, Chungbuk National University, Cheongju, Korea.
- 9National Institute of Agricultrural Science and Technology, RDA, Suwon, Korea.
Abstract
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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.
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