| 원저 : 한국의 Amatoxins 중독증 ( Amatoxins Poisonings in Korea ) |
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| Amatoxins Poisonings in Korea |
| Byung-Min Ahn, M.D., Dong-Soo Lee, M.D., Kang-Moon Lee, M.D., Sang-Bum Kang, M.D.,
Jin-Mo Yang, M.D., Young-Min Park, M.D., Young-Sok Lee, M.D., Kyu-Won Chung, M.D., Hee-Sik Sun,
Doo-Ho Park, M.D., Hyun-Joo Rho, M.D.1, Young-Mo Kang, M.D.1, Jong-Myung Lee, M.D.1,
Jung-Wook Hur, M.D.2, Sung-Gon Choi, M.D.3, Jeong-Ho Kim, M.D.4, Sang-In Lee, M.D.4,
Seung-Ok Choi, M.D.5, Hong-Youp Choi, M.D.6, Oh-Sun Kwon, M.D.6, Chang Duck Koo, Ph.D.7,
Soon-Ja Seok, Ph.D.8 and Yang-Sup Kim, Ph.D.8 |
| Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Kyungpook University1, Taegu, Keimyung University2, Taegu, Kwon Hospital3, Yechon, Yonsei University4, Seoul, Wonju College of Medicine5, Wonju, Pochon Cha University6, Pochon, School of Forest Resources, Chungbuk National University7, Cheongju, National Institute of Agricultrural Science and Technology, RDA8, Suwon, Korea |
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| ABSTRACT |
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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. |
| KeyWords:
amatoxins, mortality, Amanita virosa, A. subjunquillea. |
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