Mantar Zehirlenmeleri

Abstract

Mantarlar doğada yaygın olarak bulunurlar. Bazı toksik mantar türlerinin tüketilmesi ciddi zehirlenmeye neden olabilir. Mantarlar çoğunlukla iyi seyirli ve gastrointestinal bulguların ön planda olduğu zehirlenme tablosuna neden olurlar. Mantarın türüne bağlı farklı klinik sonuçlara neden olan bu zehirlenmelerde, amatoksin gurubu mantarlar yüksek ölüm oranına sahip olmaları nedeniyle önem taşırlar. Mantar türleri ve ortaya çıkan klinik sorunların bilinmesi uygun tedavi planının oluşturulmasına olumlu katkı sağlar. Ülkemizde bölgesel özellik göstermekle birlikte, doğadan toplanan yabani mantarların tüketimi önemli bir sorundur. Bu nedenle mantar satışının yeterli kontrolü ve toplumun bu konuda bilinçlendirilmesi bu tip zehirlenmelere bağlı ölümleri azaltabilir. Bu yazıda mantar zehirlenmelerinin genel özellikleri, tipleri, güncel tedavi yaklaşımları ve mantar zehirlenmelerinde alınabilecek tedbirler değerlendirilmiştir. Mushroom Poisonings Mushrooms are commonly found in the nature. Ingestion of some kind of toxic mushrooms may cause serious toxicity. Mushrooms poisoning are mostly characterized by mild gastrointestinal findings and good clinical course. In this poisoning, different clinical results may be seen according to the type of ingested mushrooms. Ingestion of wild mushrooms that contain amatoxin is especially important because of the high mortality. Determination of the type of toxic mushrooms and prediction of clinical outcome may serve positive contribution to planning of therapy. The ingestion of wild mushrooms picked up from nature is an important clinical problem in our country. Therefore, the restriction of selling wild mushrooms and the education of people about results of this poisoning may decrease the mortality. In the present study, general characteristics of mushroom poisoning, types of mushrooms, recent therapy methods, and preventing precautions were evaluated.

Keywords

• -

References

1. Lee E. Extraordinary mushrooming. The San Diego Tribune, April 9, 1997.
2. Berger KJ, Guss DA. Mycotoxins revisited: Part I. J Emerg Med. 2005; 28: 53–62.
3. Lehmann PF, Khazan U. Mushroom poisoning by Chlorophyllum molybdites in the midwest United States. Cases and a review of the syndrome. Mycopathologia 1992;118: 3–13.
4. Brent J, Kulig K. Mushrooms. In: Haddad LM, Shannon MW, Winchester JF, eds. Clinical management of poisoning and drug overdosez, 3rd edn. Philadelphia: WB Saunders Company; 1998: 364–365.
5. Watson WA, Litovitz TL, Rodgers GC, et al. 2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2003; 21: 353–421.
6. Schneider SM, Brayer A. Mushroom poisoning. In Tintinalli JE, Kelen GD, Stapczynski JS ed. Emergency medicine. A comprehensive study guide, 5th edition. McGraw-Hill, 2000: 1317–22.
7. Tayfur M, Unluoglu I: Mushroom poisoning: An analysis of the data between 1996 and 2000. Eur J Emerg Med 2003; 46: 1071–1078.
8. Durukan P, Yildiz M, Cevik Y, et al. Poisoning from wild mushrooms in Eastern Anatolia region: analyses of 5 years. Hum Exp Toxicol 2007; 26: 579–582.

9. Ergüven M, Çak1 S, Deveci M. Mantar zehirlenmesi: 28 vakanın değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi 2004; 47: 249–253.
10. Cataletto ME. Toxicity, Mushrooms. http://www. emedicine.com/emerg/topic874.htm 12.03.2008.
11. Goldfrank LR: Mushrooms. In: Goldfrank’s Toxicologic Emergencies. 7th edition. Goldfrank LR, Flomenbaum NE, Lewin NA, et al . Stamford, CT, Appleton & Lange, 2003, 1115–1128.
12. Schneider SM, Vanscoy G, Michelson EA: Failure of cimetidine to affect phalloidin toxicity. Vet Hum Toxicol 1991; 33: 17–18.
13. Vetter J. Toxins of Amanita phalloides. Toxicon 1998; 36: 13–24.
14. Himmelmann A, Mang G, Schnorf-Huber S. Lethal ingestion of stored Amanita phalloides mushrooms. Swiss Med Wkly 2001; 131: 616–617.
15. Jaeger A, Jehl F, Flesch F, et al. Kinetics of amatoxins in human poisoning: Therapeutic implications. J Toxicol Clin Toxicol 1993; 31: 63–80.
16. Mas A. Mushrooms, amatoxins and the liver. J Hepatol. 2005; 42: 166–9.
17. Butera R, Locatelli C, Coccini T, et al. Diagnostic accuracy of urinary amanitin in suspected mushroom poisoning: a pilot study. J Toxicol Clin Toxicol 2004; 42: 901–912.
18. Diaz JH. Evolving global epidemiology, syndromic classification, general management, and prevention of unknown mushroom poisonings. Crit Care Med. 2005 Feb; 33: 419–26.
19. Karlson-Stiber C, Persson H. Cytotoxic fungi-an overview. Toxicon 2003; 42: 339–349. 83