Ingestion of certain mushrooms can result in the Paxillus syndrome which features a hemolytic anemia and associated renal complications.
Mushrooms involved (Table 11, page 1532, Koppel):
(1) Paxillus involutus
(2) Paxillus filamentosus
(3) Clitocybe clavipes
(4) Boletus luridus
Toxin: possibly involutin
Onset: 1-2 hours after ingestion
Clinical features:
(1) collapse
(2) abdominal pain
(3) nausea and vomiting
(4) diarrhea
(5) immune hemolytic anemia with hemoglobinuria
(6) later renal failure with oliguria or anuria
where:
• The immune hemolytic anemia should be associated with a positive direct antiglobulin (Coombs) test.
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Specialty: Toxicology, Emergency Medicine, Critical Care
