Amatoxin Poisoning: An Updated Review
Year: 2025
Type: article
Abstract: Amatoxin-containing mushrooms—principally from the genera Amanita, Lepiota, and Galerina—cause the majority of fatal mushroom poisonings worldwide due to their potent inhibition of RNA polymerase II and the resultant hepatocellular necrosis. Characterized by a delayed onset of symptoms, amatoxin poisoning frequently leads to acute liver and renal failure, with mortality ranging from 10% to 30% without liver transplantation. This review catalogs relevant mushroom species, explores molecular and physiological mechanisms of toxicity, delineates diagnostic tools (e.g., HPLC, urine detection, Meixner test), and outlines management strategies—including activated charcoal, penicillin, N-acetylcysteine (NAC), silymarin/silibinin (Legalon® SIL), and supportive care—with the role of liver transplantation in severe cases. Advances in rapid detection methods, like portable test strips, are also discussed. The aim is to enhance early recognition and improve treatment outcomes.
Authors: Salima Elfagi, Faiza Nouh, Mohamed H Buzgeia
Institution: University of Benghazi
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4414806578
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