PDF(Pubmed)
Abstract：
We encountered a case of mushroom intoxication complicated by \"toxic-like\" myocarditis. Because of the lack of systematized knowledge on this subject, we performed a systematic review of the literature on cardiac toxicity in mushroom poisoning (MP). The aim of this study was to identify and describe the severity, the causal relationship, and the mushroom species involved in other reported cardiac events associated with MP. We included 39 studies in our review. We found 106 cases of cardiac events associated with MP, including 18 deaths. A wide variety of cardiac manifestations were reported, ranging from the simple elevation of cardiac enzymes (n = 61) to ventricular tachycardia (n = 14), acute heart failure (n = 18), and myocarditis (n = 7). Causal relationship between cardiac manifestations and mushroom poisoning was assessed for 42 patients, applying the algorithm validated by the French Toxicovigilance Coordination Committee. Twenty-three cases (54.8%) had a \"possible\" causal relationship, eight cases (19%) a \"probable\" relationship, and ten cases (23.8%) a \"very probable\" relationship. Several fungal genera were involved in reported cases, including Amanita but also rarer ones like Russula and Tricholoma. In conclusion, we showed that cases of cardiac toxicity following MP have been documented in the existing literature, and for some of them, we assessed a strong causal relationship.
摘要：
我们遇到了一例蘑菇中毒并发“毒性样”心肌炎的病例。由于缺乏关于这一主题的系统化知识，我们对蘑菇中毒(MP)的心脏毒性相关文献进行了系统综述.这项研究的目的是识别和描述严重程度，因果关系,以及与MP相关的其他报告心脏事件有关的蘑菇物种。我们纳入了39项研究。我们发现106例与MP相关的心脏事件，包括18人死亡。报告了各种各样的心脏表现，从心肌酶的简单升高（n=61）到室性心动过速（n=14），急性心力衰竭（n=18），和心肌炎（n=7）。对42例患者的心脏表现与蘑菇中毒之间的因果关系进行了评估，应用法国毒物警戒协调委员会验证的算法。23例(54.8%)有“可能”的因果关系，8例(19%)“可能”关系，和10例(23.8%)“非常可能”的关系。报告的病例涉及几个真菌属，包括Amanita，但也包括Russula和Tricholoma等稀有物种。总之,我们表明，在现有文献中已经记录了MP后的心脏毒性病例，对他们中的一些人来说，我们评估了一个强的因果关系。
