People who repeatedly eat Paxillus mushrooms are at risk for an immune hemolytic anemia.
Mechanism:
(1) repeated exposures to Paxillus mushrooms can sensitize the patient to Paxillus antigens
(2) after ingestion of Paxillus mushrooms antigens can circulate in the blood
(3) antibodies against Paxillus and the antigens form immune complexes which stick to red cell membranes
(4) the immune complexes bind complement which result in hemolysis
The immune hemolysis can be severe, resulting in acute renal failure, DIC and/or shock. In severe cases plasma exchange can be used to remove the antigen and immune complexes.
Diagnostic features:
(1) history of eating Paxillus mushrooms
(2) anti-Paxillus antibodies in the serum
(3) positive antiglobulin test for IgG and complement
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