Acromelalga Syndrome

Classification according to ICD-10
T62	Toxic effect of other harmful substances ingested with food
T62.0	Eat mushrooms
ICD-10 online (WHO version 2019)

The Acromelalga syndrome is a form of mushroom poisoning , which was first known only in Asia, but now occurs in Europe (2001 in France ). This rare type of mushroom poisoning was first described in Japan and has been known since 1918. Current cases from East Asia continue to be reported.

Toxic mushrooms

The representatives of the genus Paralepistopsis (at that time assigned to Clitocybe ) were recognized as poisonous mushrooms producing acromelalga syndrome :

Perfumed funnel , also called "fragrant funnel", Paralepistopsis amoenolens
the Japanese bamboo funnel , Paralepistopsis acromelalga

Triggering fungal toxins

The acromelic acids
Acromelic acid A.
Acromelic acid B

In addition to acromelic acid , other ingredients, some of which have not yet been clarified, are involved in acromelalga syndrome. B. clitidine, β-cyano-L-alanine and N- (γ-L-glutamyl) -β-cyano-L-alanine.

Symptoms

The following symptoms of poisoning can be identified: tingling, burning, pain, swelling and reddening of the skin of an intermittent nature on the hands and feet. The symptoms last from days to many weeks. There are no gastrointestinal symptoms.

The latency period is one to two (up to seven) days; Among the known mushroom poisons , acromelic acid is only surpassed by orellanine in terms of latency.

therapy

High doses of analgesics are prescribed to counteract severe pain and the effects it causes, such as exhaustion, depression and insomnia . A new therapeutic approach is the permanent administration of nicotinic acid, which counteracts the cause of the poisoning and thus significantly alleviates the symptoms.

literature

K. Nakamura, F. Shoyama, J. Toyma, K. Tateishi: Empoisonnement par le Dokou-sassa-ko. In: Jap. J. Tox. 1987, pp. 35-39.
K. Konno, K. Haahimoto, Y. Ohfune, H. Shirahama, Matsumoto T: Acromelic acids A and B. Potent neuroexcitatory amino acids isolated from Clitocybe acromelalga. In: J. Am. Chem. Soc. 110, 1988, pp. 4807-4815.
PF Saviuc, VC Danel, PA Moreau, DR Guez, AM Claustre and others: Erythromelalgia and mushoroom poisoning. In: J Toxicol Clin Toxicol . 39, 2001, pp. 403-407.
T. Stijve: Beware of these brown Clitocybes! - a new poisonous mushroom in Europe. In: Field Mycology. 2 (3), 2001, pp. 77-79.

Web links

Poisoning Syndromes - 2.3. Acromelalga Syndrome. In: dgfm-ev.de. German Society for Mycology eV, December 4, 2015, accessed on April 12, 2020 .
New mushroom poisons ( Memento from September 27, 2007 in the Internet Archive )

Individual evidence

↑ René Flammer, Egon Horak: Poison mushrooms - mushroom poisons: mushroom poisoning; a reference work for doctors, pharmacists, biologists, mycologists, mushroom experts and mushroom pickers . [Completely revised. New edition] edition. Schwabe, Basel 2003, ISBN 3-7965-2008-1 .
↑ ^a ^b ^c ^d ^e René Flammer: The Acromelalga Syndrome - a rare mushroom poisoning . In: Swiss journal for mushroom science . tape 2002 , 2002, pp. 55–58 ( mycopedia.ch [PDF; accessed April 12, 2020]).
↑ ^a ^b ^c ^d ^e Philippe F. Saviuc, Vincent C. Danel, Pierre-Arthur M. Moreau, Daniel R. Guez, Anne M. Claustre, Patrick H. Carpentier, Michel P. Mallaret, Roland Ducluzeau: Erythromelalgia and Mushroom Poisoning . In: Clinical Toxicology . tape 39 , no. 4 , 2001, p. 403-407 .
↑ ^a ^b Ichimura, J .: A new poisonous mushroom . In: Bot Gaz (Tokyo) . tape 65 , 1998, pp. 109-111 .
↑ ^a ^b ^c N. Nakajima, M. Ueda, N. Higashi, Y. Katayama: Erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 5 , June 2013, ISSN 1556-3650 , p. 451-454 , doi : 10.3109 / 15563650.2013.792933 .
^ Paralepistopsis. Retrieved April 12, 2020 .
↑ ^a ^b Nobuhito Nakajima, Masayuki Ueda, Naoyuki Higashi, Yasuo Katayama: Therapeutic potential of nicotinic acid in erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 8 , September 2013, ISSN 1556-3650 , p. 815-815 , doi : 10.3109 / 15563650.2013.823202 .
↑ Shinji Fushiya, Seiichi Sato, Genjiro Kusano, Shigeo Nozoc: β-Cyano-l-alanine and N- (γ-l-glutamyl) -β-cyano-l-alanine, neurotoxic constituents of Clitocybe acromelalga . In: Phytochemistry . tape 33 , 1993, pp. 53 .
↑ Nobuhito Nakajima, Masayuki Ueda, Naoyuki Higashi, Yasuo Katayama: Therapeutic potential of nicotinic acid in erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 8 , September 2013, ISSN 1556-3650 , p. 815-815 , doi : 10.3109 / 15563650.2013.823202 .

[1] René Flammer, Egon Horak: Poison mushrooms - mushroom poisons: mushroom poisoning; a reference work for doctors, pharmacists, biologists, mycologists, mushroom experts and mushroom pickers . [Completely revised. New edition] edition. Schwabe, Basel 2003, ISBN 3-7965-2008-1 .

[:0-2] René Flammer: The Acromelalga Syndrome - a rare mushroom poisoning . In: Swiss journal for mushroom science . tape 2002 , 2002, pp. 55–58 ( mycopedia.ch [PDF; accessed April 12, 2020]).

[:1-3] Philippe F. Saviuc, Vincent C. Danel, Pierre-Arthur M. Moreau, Daniel R. Guez, Anne M. Claustre, Patrick H. Carpentier, Michel P. Mallaret, Roland Ducluzeau: Erythromelalgia and Mushroom Poisoning . In: Clinical Toxicology . tape 39 , no. 4 , 2001, p. 403-407 .

[:2-4] Ichimura, J .: A new poisonous mushroom . In: Bot Gaz (Tokyo) . tape 65 , 1998, pp. 109-111 .

[:3-5] N. Nakajima, M. Ueda, N. Higashi, Y. Katayama: Erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 5 , June 2013, ISSN 1556-3650 , p. 451-454 , doi : 10.3109 / 15563650.2013.792933 .

[6] Paralepistopsis. Retrieved April 12, 2020 .

[:4-7] Nobuhito Nakajima, Masayuki Ueda, Naoyuki Higashi, Yasuo Katayama: Therapeutic potential of nicotinic acid in erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 8 , September 2013, ISSN 1556-3650 , p. 815-815 , doi : 10.3109 / 15563650.2013.823202 .

[8] Shinji Fushiya, Seiichi Sato, Genjiro Kusano, Shigeo Nozoc: β-Cyano-l-alanine and N- (γ-l-glutamyl) -β-cyano-l-alanine, neurotoxic constituents of Clitocybe acromelalga . In: Phytochemistry . tape 33 , 1993, pp. 53 .

[9] Nobuhito Nakajima, Masayuki Ueda, Naoyuki Higashi, Yasuo Katayama: Therapeutic potential of nicotinic acid in erythromelalgia associated with Clitocybe acromelalga intoxication . In: Clinical Toxicology . tape 51 , no. 8 , September 2013, ISSN 1556-3650 , p. 815-815 , doi : 10.3109 / 15563650.2013.823202 .