This lethal lineup of mushrooms contains amatoxins, which include alpha, beta, and gamma amanitin. Amatoxin poisoning accounts for more than 90 percent of all deaths resulting from mushroom poisoning worldwide. Part of what makes them so deadly is that they can easily be confused with other, completely edible mushrooms. Death caps, for instance, can look much like straw and Gypsy mushrooms. The various destroying angels can be mistaken for button, meadow, and horse mushrooms. In Cleveland, Gholam recently treated a patient who had eaten a deadly Amanita mushroom he found in his yard after a plant identification app on his phone identified the mushroom as an edible variety. It almost killed him.

The mushrooms’ amatoxins are easily absorbed through the gastrointestinal tracts once they’ve been eaten. From there, the toxins head to the kidneys and, in particular, the liver, which is one of the most important organs in the body for making proteins. Amatoxins work by blocking a key enzyme involved in making new proteins, called RNA polymerase type II. In the liver, blocking this enzyme causes a cascade of trouble that results in cell death and tissue necrosis. While some of the toxin ultimately gets flushed in urine, some gets transported out of the liver with bile acids, where they end up back in the intestines for the process to begin again—in what’s called an enterohepatic cycle.

After ingestion, symptoms only appear six to 24 hours later, once significant damage has accumulated. Then the poisoning proceeds through three distinct phases. First, there’s gastrointestinal distress—marked by excruciating abdominal pain, nausea, vomiting, diarrhea, and blood in the urine—and can sometimes be accompanied by rapid heartbeat, low blood sugar, and dehydration. All that can last for 12 to 36 hours. Then, there’s the second, “latent” phase, when symptoms quiet down as liver and kidney damage set in at about 72 hours. In this phase, a person may be lulled into thinking they’re in the clear, potentially causing them to decline emergency medical care that could save their life.

In the three-to-five days after ingestion, things go downhill, with abrupt liver and multi-organ failure. Some patients end up needing liver transplants. Fatality rates vary but sometimes range between 10 and 20 percent, though some studies have found higher rates.

There are no specific treatments for amatoxin poisoning.

Ohio foragers are accidentally poisoning themselves with lethal mushrooms — https://arstechnica.com/science/2022/10/ohio-foragers-are-accidentally-poisoning-themselves-with-lethal-mushrooms/

“…a plant identification app on his phone identified the mushroom as an edible variety.”

Go ahead and search for the phrase “mushroom identification app” in your favorite search engine.

Foraging for wild mushrooms is a perfect example of you don’t know what you don’t know even if an app on your phone leads to believe you know.