amanitins and Hypertension

We report four cases of poisoning with amatoxin-producing mushrooms in suburban Long Island. All occurred when amateur mushroom hunters picked mushrooms from neighboring lawns. Two patients presented 30 hours post ingestion with evidence of acute hepatic dysfunction. One survived, after treatment with charcoal and penicillin; the other, a 90-year-old woman with prior cardiac disease soon developed shock and subsequently died. The other two patients were admitted 18 hours after ingestion of Lepiota chlorophyllum and received prompt charcoal hemoperfusion. Both did well, although one had a mild elevation of transaminases. Although most reports of amatoxin poisoning originate in Europe, these cases confirm that amatoxin-producing mushrooms, including Lepiota chlorophyllum, may be found in northeastern American suburbs. Such patients who present prior to 24 hours after ingestion should receive charcoal hemoperfusion if a lethal dose (> 50 g of mushroom) has been eaten.

Topics: Adult; Aged; Aged, 80 and over; Amanita; Amanitins; Basidiomycota; Fatal Outcome; Female; Heart Block; Humans; Hypertension; Male; Middle Aged; Mushroom Poisoning; New York; Thyroiditis, Autoimmune

Environmental stress factors, including temperature, modify the severity of hypertension, a genetic disease. Hypertensive animals and humans respond abnormally to heat exposure, and this abnormality is reflected at the cellular level by an increment in a major stress (heat-shock) gene expression. The present studies demonstrate that increased hsp70 gene expression is due to its heightened transcription rate. The genetic basis of environmental susceptibility to hypertension may thus involve an abnormal control of heat shock genes.

Topics: Amanitins; Animals; Gene Expression Regulation; Genes; Heat-Shock Proteins; Hypertension; Mice; Mice, Inbred Strains; Reference Values; RNA, Messenger; Stress, Physiological; Transcription, Genetic