症例 challenge · Emergency / Toxicology / Hepatology · teaching

Mushroom (Amatoxin) Poisoning Pathway · case challenge

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Case #1Emergency / Toxicology / Hepatology

📋 Case data

Time of onset of GI symptomsGI symptoms starting >6 h after ingestion (suspect amatoxin)

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Step 1 / 1 · Time of onset of GI symptoms

Time of onset of GI symptoms after eating wild mushrooms?

💡 Amatoxin-containing mushrooms (Amanita etc., a major lethal cause of wild-mushroom poisoning in China). Alpha-amanitin inhibits RNA polymerase II → hepatocyte apoptosis. Phases: 1) latency 6–12 h (asymptomatic, the delayed onset is the key, distinguishing it from early-onset benign gastrointestinal mushroom toxicity), 2) GI phase (6–24 h, cholera-like severe vomiting/diarrhea, fluid loss), 3) pseudo-recovery (24–72 h, symptoms ease but transaminases rise), 4) hepatic-renal failure (3–5+ days, acute liver failure, coagulopathy, multi-organ failure).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.