Poisoning with Amanita phalloides mushrooms results in histopathologic changes affecting a number of organs, especially the liver and kidneys.
Clinical findings:
(1) hepatic failure
(2) renal failure with aminoaciduria (may develop cysteine and/or tyrosine crystals)
(3) coma
(4) coagulopathy
(5) respiratory failure
Grossly the liver in a fully developed intoxication shows acute yellow atrophy.
Hepatic Changes
Stage
cytoplasmic vacuoles within hepatocytes that contain an eosinophilic granular material
1
lysosomal fusion
2
massive centrilobular necrosis and intralobular hemorrhage
3
Renal changes:
(1) dark red color from interstitial hemorrhage
(2) acute tubular necrosis with eosinophilic intra-tubular casts
Other organ involvement:
(1) cerebral edema
(2) bleeding into lungs or other organs
Amanitin can be measured in urine to confirm the diagnosis.
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Specialty: Toxicology, Emergency Medicine, Critical Care
ICD-10: ,
