한국의 Amatoxins 중독증

Abstract

Background/Aims : From the review of Korean literature most fatal mushroom poisonings have been due to amatoxins with high mortality. So far there have never been investigations on the amatoxins poisonings such as annual incidence, mortality, common causal species, and endemic areas. This study was carried out to develop some basic statistics as part of studies for an effective management of amatoxins intoxications . Method: For the year 1999 authors collected cases of mushroom poisonings which had been mainly gathered from hospitals nation- wide. All of the cases with suggestive amatoxins poisonings were screened by symptomatology and laboratory findings . The causal species of mushrooms were identified grossly and microscopically. Res ults : A total of 54 victims with mushroom poisonings were evaluated. The causal mushroom toxins were diagnosed or strongly sugges ted as amatoxins in 43 of 54 victims. Eleven of 54 victims did not conform to the category of amatoxins intoxication due to absent or minimal elevation of aminotrans ferase. Mean age of the victims was 44.3 ± 23.3 (range: 7- 78) with male predominance (1.2 : 1). The causal species were confirmed, or strongly suggested, as Amanita virosa in 25 victims, Amanita subjunquillea in 14, and unknown species in 4. Thirty- five out of a total of 43 were regarded as moderate to severe intoxication (AST or ALT > 1,000 IU/L) with 20% mortality. Most fatal victims showed marked thrombocytopenia (40,000 ± 1a9,000/mm3) compared to non- fatal victims (109,066 ± 42,245/mm3). A total of 88.4% of victims was developed in the Kangwon and Kyungpuk provinces. Both are wes t of the Taebaek Mountains (38/43). Conclus ions : Although the common causal species for amatoxins poisonings in Korea are different from European countries and North America, the mortality is similar to that of those areas. In order to further reduce the mortality, beds ide diagnostic methods us ing biological fluids and more effective therapy for liver failure should be established.