Clinical Toxicology最新文献

{"title":"A prospective study of acute propranolol overdose defining dose thresholds of severe toxicity (ATOM - 9).","authors":"Katherine Z Isoardi, Angela L Chiew, Cuong Do, Michael Humphreys, Ahmead Mustafa, Michael S Roberts, Geoffrey K Isbister","doi":"10.1080/15563650.2024.2435397","DOIUrl":"10.1080/15563650.2024.2435397","url":null,"abstract":"<p><strong>Introduction: </strong>Propranolol is a beta-adrenoceptor blocking drug with sodium channel-blocking properties that can cause life-threatening toxicity in overdose. Limited research defines dose thresholds of toxicity. We aimed to investigate propranolol overdose and dose thresholds for severe toxicity.</p><p><strong>Material and methods: </strong>This is a prospective series of patients with acute propranolol overdose ≥360 mg from August 2014 to December 2023 enrolled through the Australian TOxicology Monitoring (ATOM) collaboration. Severe toxicity was defined as seizure, coma, inotrope therapy, electrocardiographic evidence of sodium channel blockade, or cardiac arrest.</p><p><strong>Results: </strong>There were 209 presentations in 165 patients (median age 30 years [range 15-80 years]; 117 females, 71%). The median reported dose ingested was 1,000 mg (IQR: 600-2,000 mg; range 360-16,000 mg). Co-ingestion occurred in 155 (74%) patients, most commonly involving benzodiazepines (<i>n</i> = 52). Bradycardia (heart rate <50 beats/min) occurred in 41 (20%), and hypotension (systolic blood pressure <90 mmHg) in 88 (42%). Severe toxicity occurred in 51 patients (24%), with 17 (8%) having a seizure and 29 (14%) developing coma. Forty-one (20%) received inotropes, including 31(15%) who were given epinephrine and 20 (10%) high-dose insulin. Electrocardiographic evidence of sodium channel blockade occurred in 16 (8%). Seven (3%) had a cardiac arrest (reported dose range 2,400-16,000 mg), with two deaths following the ingestion of propranolol 4,000 mg and 16,000 mg. The median length of stay was 17 h (IQR: 11-32 h). In 79 patients who ingested only propranolol, the lowest reported propranolol dose for hypotension was 400 mg and for bradycardia, 800 mg. The lowest reported dose for severe toxicity was propranolol 2,000 mg. In those ingesting propranolol only, 17 of 32 (53%) patients who ingested ≥2,000 mg had severe toxicity.</p><p><strong>Discussion: </strong>Severe toxicity was common, occurring in a quarter of all propranolol overdoses and half of the isolated propranolol ingestions (≥2,000 mg). The outcome was usually favourable with good supportive care, even in severe toxicity.</p><p><strong>Conclusion: </strong>The dose threshold for severe toxicity in isolated propranolol overdose appeared to be 2,000 mg.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe food-induced methaemoglobinaemia.","authors":"Alix-Marie Pouget, Fanny Pélissier, Philippe Fournier, Nicolas Delcourt","doi":"10.1080/15563650.2024.2418982","DOIUrl":"10.1080/15563650.2024.2418982","url":null,"abstract":"","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"64-65"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on West et al. \"Identifying and quantifying exposures involving counterfeit opioid analgesic products\".","authors":"Yun-Ling Liu, Lien-Chung Wei","doi":"10.1080/15563650.2024.2421862","DOIUrl":"10.1080/15563650.2024.2421862","url":null,"abstract":"","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"67-68"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing toxicovigilance of recreational drugs, including new psychoactive substances, by using data from four European poison centres.","authors":"Aza Kader, Maren Hermanns-Clausen, Antoinette van Riel, Katrin Faber, Laura Hondebrink","doi":"10.1080/15563650.2024.2430311","DOIUrl":"10.1080/15563650.2024.2430311","url":null,"abstract":"<p><strong>Introduction: </strong>Common recreational drugs and new psychoactive substances pose challenges to public health. This study investigated the feasibility of merging cases of recreational drug poisoning reported to European poison centres.</p><p><strong>Methods: </strong>Four European poison centres (Freiburg, Germany; the Netherlands; Sweden and Switzerland) collaborated in a retrospective, observational study. We collected aggregated data on poisonings with 11 common recreational drugs and case-by-case data on poisonings with new psychoactive substances in 2021 by using anonymized data from electronic case reports.</p><p><strong>Results: </strong>In 2021, 2.0% of the poison centre calls involved poisonings with recreational drugs. The poison centres were contacted about 3,705 patients, involving 4,380 drug exposures, of which 3,708 were common recreational drugs, and 672 were new psychoactive substances. Per million inhabitants, the poisoning rate with common recreational drugs varied between 48 (Freiburg) and 145 (Sweden). Poisonings with amfetamine (22%), cocaine (20%), all delta-9-tetra-hydrocannabinol-containing preparations (20%), and 3,4-methylenedioxymetamfetamine (13%) exposures were most frequent. The poisoning rate per million inhabitants with new psychoactive substances varied between two (Switzerland) and 29 (Netherlands). Cathinones (43%), designer benzodiazepines (28%), and phenethylamines (13%) were the most commonly involved new psychoactive substance classes. Symptoms following cathinone poisoning were tachycardia (35%) and hypertension (13%), while following designer benzodiazepines, somnolence was most prominent (38%). The majority of users of new psychoactive substances were male (67%), 55% were between 18 and 30 years, and 8% involved minors (<18 years).</p><p><strong>Discussion: </strong>This study showed the feasibility of merging data on recreational drug poisoning collected by poison centres in four countries. Despite underestimating the overall incidence of drug-related health incidents, poison centre data offers national coverage, unlike other data sources, such as drug-related emergency department visits.</p><p><strong>Conclusion: </strong>This multi-centre, multi-national study reported a substantial annual number of recreational drug poisonings, with a variable proportion of new psychoactive substances. It shows that poison centre data offers detailed insights into exposures to common recreational drugs and new psychoactive substances, user characteristics, and symptoms. It can be used for comprehensive monitoring of drug-related health incidents on a multi-national level.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"23-31"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply to comment on Hayman et al. \"elevated osmol gaps in patients with alcoholic ketoacidosis\".","authors":"Chelsea V Hayman, Kyle D Pires, Emily T Cohen, Rana Biary, Mark K Su, Robert S Hoffman","doi":"10.1080/15563650.2024.2440551","DOIUrl":"10.1080/15563650.2024.2440551","url":null,"abstract":"","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"70-71"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world delays in antivenom administration: patient, snake or hospital factors (ASP-33).","authors":"Geoffrey K Isbister, Angela L Chiew, Nicholas A Buckley, Jessamine Soderstrom, Simon Ga Brown, Shane Jenkins, Katherine Z Isoardi","doi":"10.1080/15563650.2024.2433125","DOIUrl":"10.1080/15563650.2024.2433125","url":null,"abstract":"<p><strong>Objective: </strong>Early antivenom administration is essential for effective treatment. We investigated the delays in antivenom administration.</p><p><strong>Methods: </strong>We reviewed snakebites from the Australian Snakebite Project (2006-2021) given antivenom, presenting to hospital within 12 h. We extracted demographics, snake type, time of bite, hospital arrival, blood collection, antivenom treatment and hospital transfer.</p><p><strong>Results: </strong>There were 2,169 patients recruited to Australian Snakebite Project 1,132 patients received antivenom within 12 h of the bite, and 1,019 of these were envenomated: median age 41 years (IQR: 24-57 years); 738 (72%) males. A pressure bandage was applied in 950 (93%), a median of 15 min (IQR: 5-30 min) post-bite. Specific snakes were identified by venom assays in 855 patients (80%), including 328 brown snakes (32%), 173 tiger snakes (17%), 74 rough-scaled snakes (7%), 85 red-bellied black snakes (8%), 49 taipans (5%) and 26 death adders (3%). Seventy-seven patients (7%) received antivenom without envenomation. The median length of hospital stay was 41 h (IQR: 24-67 h). The median time to hospital was 60 min (IQR: 30-105 min), to first blood tests was 90 min (IQR: 59-154 min) and to antivenom was 235 min (IQR: 155-345 min). There was a median delay in blood tests of 20 min (IQR: 10-37 min) and a median delay to antivenom of 147 min (IQR: 84-249 min). Non-specific systemic symptoms occurred in 641 (63%) patients, which occurred a median of 24 min (IQR: 10-60 min) post-bite, which was at a median of 180 min (IQR: 106 to 275 min) prior to antivenom administration. Time to antivenom in the 314 transferred patients was similar to those not transferred. Time to antivenom was significantly shorter for 189 patients given antivenom prior to transfer, median 183 min (IQR: 110-270 min), compared to 130 patients given antivenom after transfer, median 363 min (IQR: 289-513 min; <i>P</i> <0.001).</p><p><strong>Discussion: </strong>Antivenom administration was delayed on average by 2.5 h after hospital presentation, despite three-quarters arriving in hospital within 3 h, the optimal time for antivenom administration. Patients requiring transfer received antivenom in a similar time, but earlier if administered prior to transfer, highlighting the possible benefits of pragmatic clinical decision-making prior to blood tests.</p><p><strong>Conclusion: </strong>We found the leading cause of delays to antivenom administration after patients arrive in hospital was waiting for blood results. Systemic symptoms occurred early in most cases and could be given greater weight in decisions about early antivenom.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"10-15"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 Annual Report of the National Poison Data System® (NPDS) from America's Poison Centers®: 41st Annual Report.","authors":"David D Gummin, James B Mowry, Michael C Beuhler, Daniel A Spyker, Laura J Rivers, Ryan Feldman, Kaitlyn Brown, Nathaniel P T Pham, Alvin C Bronstein, Carol DesLauriers","doi":"10.1080/15563650.2024.2412423","DOIUrl":"10.1080/15563650.2024.2412423","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;This is the 41&lt;sup&gt;st&lt;/sup&gt; Annual Report of America's Poison Centers® National Poison Data System®. As of 1 January, 2023, all 55 of the nation's poison centers uploaded case data automatically to NPDS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed the case data, tabulating specific indices from the NPDS®. The methodology was as in previous years. Where changes were introduced, the differences are identified. Cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologists using an ordinal scale of 1-6 to assess the Relative Contribution to Fatality of the exposure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 2023, 2,421,251 closed encounters were logged by the National Poison Data System®: 2,080,659 human exposures, 41,857 animal exposures, 293,663 information requests, 5,046 human confirmed nonexposures, and 26 animal confirmed nonexposures. The upload interval was 4.88 [4.43, 9.33] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. Total encounters showed a 2.49% decrease from 2022 while human exposure cases increased by 0.764% and health care facility human exposure cases increased by 2.38%. All information requests decreased by 19.1%, medication identification (Drug ID) requests decreased by 14.0%, and medical information requests showed a 61.3% decrease, returning to pre-COVID-19 pandemic numbers. Drug Information requests showed a 17.6% decrease, due to continued declining COVID-19 vaccine calls to poison centers, but these still comprised 21.7% of all information contacts. Human exposures with less serious outcomes have decreased by 1.58% per year since 2008, while those with more serious outcomes (moderate, major or death) have increased by 4.25% per year since 2000.Consistent with the previous year, the top 4 substance classes most frequently involved in all human exposures were analgesics (11.00%), household cleaning substances (7.12%), antidepressants (5.58%), and cosmetics/personal care products (5.01%). Cardiovascular drugs (4.97%) replaced antihistamines as the 5&lt;sup&gt;th&lt;/sup&gt; most common substance class. As a class, analgesic exposures increased most rapidly, by 1,260 cases/year (2.72%/year) over the past 10 years for cases with more serious outcomes.The top 5 most common exposures in children aged 5 years or less were household cleaning substances (10.1%), analgesics (9.13%), cosmetics/personal care products (9.10%), foreign bodies/toys/miscellaneous (8.03%), and dietary supplements/herbals/homeopathic (6.88%). The National Poison Data System® documented 3,272 human exposures resulting in death; 2,700 (82.5%) of these were judged as related (Relative Contribution to Fatality of 1-Undoubtedly responsible, 2-Probably responsible, or 3-Contributory).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These data support the continued value of poison center expertise and the need for specialized medical toxicology informa","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"793-1027"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Poison Data System^® Annual Report: under the hood.","authors":"James B Mowry","doi":"10.1080/15563650.2024.2429442","DOIUrl":"https://doi.org/10.1080/15563650.2024.2429442","url":null,"abstract":"<p><strong>Introduction: </strong>The 41st National Poison Data System^® Annual Report from America's Poison Centers^® is published in this issue of <i>Clinical Toxicology.</i> This Commentary focuses on comparing the different poisoning-related surveillance systems in the United States while highlighting some of the strengths and weaknesses of the National Poison Data System^®. It also reviews the process underlying the fatality review section of the Annual Report.</p><p><strong>Comparison of poisoning surveillance systems: </strong>In order to place the data reported by the National Poison Data System^® in context, the National Poison Data System^® was compared to other available poisoning surveillance systems in the United States: the American College of Medical Toxicology's Toxicology Investigators Consortium (ToxIC) Registry, the Centers for Disease Control and Prevention Injury Prevention and Control Web-based Injury Statistics Query and Reporting System (WISQARS^™) which partners with the Consumer Products Safety Commission's National Electronic Injury Surveillance System - All Injury Program (NEISS-AIP), and the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database. Differences exist in the scope and focus of these databases, including the underlying population base and sources of reporting, use of statistical sampling, type of medical outcomes reported, type and number of products/substances reportable, granularity of product/substances reported, case volumes, timeliness of reporting and surveillance activities.</p><p><strong>National poison data system fatality review process: </strong>The National Poison Data System^® mortality data may vary from data collected by other sources but has some characteristics that render it unique, including the publication of narratives of selected fatalities. Each direct death undergoes a rigorous review by medical and clinical toxicologists at the regional poison center and by America's Poison Centers^® Fatality Review Committee. This review process is outlined in detail and compared to other poisoning mortality reporting systems.</p><p><strong>Conclusion: </strong>National Poison Data System^® data from poison centers in the United States provide a unique perspective of the epidemiology of poisoning that is distinct but complementary to other poisoning surveillance systems in the United States. The National Poison Data System^® conducts a rigorous fatality review process that incorporates a variety of inputs that provide additional verification of the poisoning fatalities reported to it. The availability of and routine publication of fatality narratives is a unique feature of the National Poison Data System^®.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":"62 12","pages":"787-792"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of hypofibrinogenemia following rattlesnake envenomation treated with crotalidae immune F(ab')₂ (equine) antivenom.","authors":"Thom S Maciulewicz, David R Axon, Farshad Mazda Shirazi","doi":"10.1080/15563650.2024.2406427","DOIUrl":"10.1080/15563650.2024.2406427","url":null,"abstract":"<p><strong>Introduction: </strong>Hemotoxicity is common following rattlesnake envenomation. Published experiences with equine-derived crotalidae immune F(ab')₂ antivenom have characterized hemotoxicity as delayed, recurrent, or persistent. This study investigated recovery of hypofibrinogenemia following rattlesnake envenomation treated with equine-derived crotalidae immune F(ab')₂ antivenom.</p><p><strong>Methods: </strong>This is a retrospective analysis of human rattlesnake envenomations reported to the Arizona Poison and Drug Information Center over four years. We included rattlesnake-envenomated patients who developed hypofibrinogenemia (<1,500 mg/L) and were treated with equine-derived crotalidae immune F(ab')₂ antivenom. The primary outcomes were recovery period (h) and recovery rate (mg/L/h) of hypofibrinogenemia following equine-derived crotalidae immune F(ab')₂ antivenom administration. Collected data included demographics, laboratory values, and antivenom administered. Statistics used were percentages, medians, and Kruskall-Wallis test.</p><p><strong>Results: </strong>There were 527 rattlesnake envenomations treated with antivenom, of which 80 met the inclusion criteria. Patients receiving treatment with F(ab')₂ antivenom and had a median fibrinogen concentration recovery rate of 62.3 mg/L/h (IQR: 42.0-74.3 mg/L/h) and median recovery period of 19.2 h (IQR: 13.8-26.2 h). There were statistically significant differences between categories for time to antivenom for the median recovery period (<i>P</i> = 0.0154).</p><p><strong>Discussion: </strong>Hypofibrinogenemia is a common laboratory finding following rattlesnake envenomation in Arizona. This study investigated rattlesnake envenomated patients treated with F(ab')₂ antivenom and monitored fibrinogen concentrations as a surrogate marker of venom toxicity. Additionally, time to administration of F(ab')₂ antivenom was a statistical significant marker of the recovery period from hypofibrinogenemia. Limitations of this study included the geographic coverage of the poison center and exclusion of patients with insufficient laboratory monitoring or those who received another antivenom.</p><p><strong>Conclusions: </strong>Following rattlesnake envenomation in Arizona, recovery from hypofibrinogenemia was able characterized in a rate (mg/L/h) and period (h) with the quantity and time to administration of antivenom. More studies are needed to assess this finding with other antivenoms and its clinical significance.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"749-753"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An outbreak of <i>Galerina sulciceps</i>-like (Galerina cf. sulciceps) mushroom poisoning.","authors":"Mengxia Cao, Shan Luo, Ting Kang, Santao Ou","doi":"10.1080/15563650.2024.2402501","DOIUrl":"10.1080/15563650.2024.2402501","url":null,"abstract":"<p><strong>Objective: </strong>Amatoxin-containing mushroom poisoning is a significant threat to public health worldwide. We report a mass poisoning of <i>Galerina sulciceps</i>-like mushrooms (Galerina cf. sulciceps) in Luzhou, Sichuan Province, China, aiming to offer insights for future prevention and treatment strategies.</p><p><strong>Methods: </strong>We performed a retrospective survey of mass mushroom poisoning patients admitted to our hospital. The demographic data, clinical presentations, laboratory findings, therapeutic measures and prognostic information were collected and analyzed. We used the 2020 Chinese consensus on the clinical diagnosis and treatment of amatoxin-containing mushroom poisoning to assess the severity of poisoning. Mushrooms were examined through morphological analysis, molecular biology identification, and toxin detection.</p><p><strong>Results: </strong>Our patient cohort consisted of nine males and six females, with mean (±SD) age of 34.9 ± 13.0 years. Gastrointestinal symptoms were the first to manifest, with mean (±SD) latency period of 13.4 ± 3.9 h. The majority of patients (86.7%) experienced nausea, vomiting, and diarrhea. Liver dysfunction was noted in 66.7% of patients, and thrombocytopenia was present in 26.7% of patients. In terms of the severity of poisoning, there were 10 mild cases and five severe cases. The mushrooms were provisionally labeled as <i>Galerina cf. sulciceps</i>, containing the toxins α-amanitin, β-amanitin, and γ-amanitin. All patients eventually recovered.</p><p><strong>Discussion: </strong>We report what appears to be a new type of mushroom that is morphologically and phylogenetically similar to the known <i>Galerina sulciceps</i>, but further study is required to determine if it represents a distinct species.</p><p><strong>Conclusion: </strong>This poisoning event was caused by unintentional ingestion of <i>Galerina cf. sulciceps</i>, an amatoxin-containing mushroom. Early symptoms are primarily gastrointestinal, with acute liver damage and coagulopathy being the main toxic effects. Thrombocytopenia is also prominent, particularly in severe cases. Accurate assessment and prompt, individualized, and intensive treatment are crucial for managing patients with acute <i>Galerina cf. sulciceps</i> poisoning effectively.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"707-713"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}