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Cómo Citar El Artículo Número Completo Más Información Del Acta Bioquímica Clínica Latinoamericana ISSN: 0325-2957 ISSN: 1851-6114 [email protected] Federación Bioquímica de la Provincia de Buenos Aires Argentina Pomilio, Alicia Beatriz; Battista, Stella Maris; Alonso, Ángel Micetismos. Parte 4: Síndromes tempranos con síntomas complejos Acta Bioquímica Clínica Latinoamericana, vol. 53, núm. 3, 2019, Septiembre-, pp. 361-396 Federación Bioquímica de la Provincia de Buenos Aires Argentina Disponible en: https://www.redalyc.org/articulo.oa?id=53562084019 Cómo citar el artículo Número completo Sistema de Información Científica Redalyc Más información del artículo Red de Revistas Científicas de América Latina y el Caribe, España y Portugal Página de la revista en redalyc.org Proyecto académico sin fines de lucro, desarrollado bajo la iniciativa de acceso abierto Toxicología Actualización Micetismos. Parte 4: Síndromes tempranos con síntomas complejos 1a 2b 3c ` Alicia Beatriz Pomilio *, Stella Maris Battista , Ángel Alonso Resumen 1 Doctora de la Universidad de Buenos Aires En esta Parte 4 de la serie de cuatro artículos sobre micetismos se analizan (Ph. D.), Investigadora Superior del CONICET. los síndromes que se caracterizan por presentar un período de latencia muy Profesora de la Universidad de Buenos Aires. corto, con la aparición de síntomas complejos en menos de 6 horas después 2 Médica. Doctorando en la Facultad de Medici- de la ingestión de los macromicetos. Se discuten los siguientes micetismos: na, Universidad de Buenos Aires. Docente en 1) Toxíndrome muscarínico o colinérgico periférico por especies de Inocy- la Facultad de Medicina (UBA). be y Clitocybe. 2) Toxíndrome inmunohemolítico o hemolítico por Paxillus. 3 Doctor en Medicina (Ph. D.), Médico, Facul- 3) Toxíndrome neumónico alérgico por Lycoperdon perlatum y por Pholiota tad de Medicina, Universidad de Buenos Aires nameko. 4) Toxíndrome panterínico o neurotóxico glutaminérgico por com- (UBA). Profesor Emérito UBA. Investigador en puestos isoxazólicos o síndrome pantherina/muscaria. 5) Toxíndrome coprí- Histología, Microbiología e Inmunología. nico o cardiovascular. 6) Toxíndrome neurotóxico alucinogénico por psiloci- bina y derivados indólicos. 7) Toxíndrome psicotrópico por estirilpironas y a Departamento de Bioquímica Clínica, Área gimnopilinas de Gymnopilus spectabilis o G. junonius. 8) Toxíndrome agudo Hematología, Hospital de Clínicas “José de de rabdomiólisis por Russula subnigricans. 9) Toxíndrome cianogénico por San Martín”, Universidad de Buenos Aires, Marasmius oreades. 10) Toxíndrome inmunosupresor por tricotecenos ma- Av. Córdoba 2351, C1120AAF Buenos Aires, crocíclicos de Podostroma cornu-damae. 11) Toxíndrome hemolítico debido Argentina. Tel: (+54) (11) 4814 3952. abpo- a ostreolisina de Pleurotus ostreatus y especies relacionadas. Se analizan [email protected]; [email protected] los síntomas, las toxinas involucradas, los mecanismos de acción, cuando b Microbiología I, Cátedra 2 (Inmunología), Facul- se conocen, y las especies causantes de los micetismos. tad de Medicina, Universidad de Buenos Aires. Correo electrónico: [email protected] Palabras clave: Micetismos tempranos; Toxíndromes con síntomas complejos; c División Alergia e Inmunología, Hospital de Lycoperdon perlatum; Pholiota nameko; Amanita pantherina/Amanita muscaria; Clínicas “José de San Martín”, Universidad de Gymnopilus spectabilis (G. junonius); Russula subnigricans; Marasmius orea- Buenos Aires. Correo electrónico: administra- des; Podostroma cornu-damae; Pleurotus ostreatus; Inocybe; Clitocybe; Paxi- [email protected] llus; Coprinopsis; Coprinus; Psilocybe; Panaeolus; Conocybe; Pluteus; Stropha- ria; Toxinas; Tratamiento * Autor para correspondencia. Mushroom poisonings. Part 4: early-onset syndromes with complex symptoms Abstract This Part 4 of the series of four articles on mushroom poisonings refers to early-onset syndromes, which are characterized by a very short latency Acta Bioquímica Clínica Latinoamericana period, and the appearance of complex symptoms in less than 6 hours after Incorporada al Chemical Abstract Service. mushroom ingestion. The following mycetisms are discussed, (1) Peripheral Código bibliográfico: ABCLDL. cholinergic, or muscarinic syndrome due to Inocybe and Clitocybe species. (2) Immunohaemolytic or haemolytic syndrome by Paxillus. (3) Allergic ISSN 0325-2957 (impresa) pneumonic syndrome due to Lycoperdon perlatum, and Pholiota nameko. ISSN 1851-6114 (en línea) (4) Glutaminergic neurotoxic, or pantherinic syndrome by isoxazole com- ISSN 1852-396X (CD-ROM) pounds or pantherina/muscaria syndrome. (5) Coprinic or cardiovascular Acta Bioquím Clín Latinoam 2019; 53 (3): 361-96 362 Pomilio AB et al. syndrome. (6) Hallucinogenic neurotoxic syndrome due to psilocybin and indole derivatives. (7) Psycho- tropic syndrome by styrylpirones and gymnopilins of Gymnopilus spectabilis or G. junonius. (8) Rhabdo- myolysis acute syndrome due to Russula subnigricans. (9) Cyanogenic syndrome by Marasmius oreades. (10) Immunosuppressive syndrome by macrocyclic trichothecenes of Podostroma cornu-damae. (11) Haemolytic syndrome due to ostreolisine of Pleurotus ostreatus, and related species. The symptoms, toxins involved, mechanisms of action, when known, and the species of mushrooms responsible for the mycetisms are analyzed. Keywords: Early-onset mycetisms; Toxindromes with complex symptoms; Lycoperdon perlatum; Pholiota nameko; Amanita pantherina/Amanita muscaria; Gymnopilus spectabilis (G. junonius); Russula subnig- ricans; Marasmius oreades; Podostroma cornu-damae; Pleurotus ostreatus; Inocybe; Clitocybe; Paxillus; Coprinopsis; Coprinus; Psilocybe; Panaeolus; Conocybe; Pluteus; Stropharia; Toxins; Treatment Intoxicações por cogumelos. Parte 4: Síndromes precoces com sintomas complexos Resumo Nesta parte 4 da série de quatro artigos sobre intoxicação por cogumelos são analisadas síndromes que se caracterizam por apresentar um período de latência muito breve, com aparecimento de sintomas complexos em menos de 6 horas após a ingestão dos macromicetos. As seguintes intoxicações com cogumelos são discutidas: (1) Toxíndrome muscarínico ou colinérgico periférico por espécies de Inocybe e Clitocybe. (2) Toxíndrome imuno-hemolítica ou hemolítica por Paxillus. (3) Toxíndrome pneumônica alérgica por Lycoperdon perlatum e por Pholiota nameko. (4) Toxíndrome panterínica ou neurotóxica glutaminérgica por compostos isoxazólicos ou síndrome pantherina/muscaria. (5) Toxíndrome coprínica ou cardiovascular (6) Toxíndrome neurotóxico-alucinogênica por psilocibina e derivados indólicos. (7) Toxíndrome psicotrópica por estirilpironas e gimnopilinas de Gymnopilus spectabilis ou G. junonius. (8) Toxíndrome aguda de rabdomiólise por Russula subnigricans. (9) Toxíndrome cianogênica por Marasmius oreades. (10) Toxíndrome imunossupressora por tricotecenos macrocíclicos de Podostroma cornu-damae. (11) Síndrome hemolítica por ostreolisina de Pleurotus ostreatus e espécies relacionadas. São analisados os sintomas, as toxinas envolvidas, os mecanismos de ação, quando conhecidos, e as espécies de cogumelos responsáveis pelas intoxicações. Palavras-chave: Intoxicações precoces por cogumelos; Toxíndromes com sintomas complexos; Lycoperdon perlatum; Pholiota nameko; Amanita pantherina/Amanita muscaria; Gymnopilus spectabilis (G. junonius); Russula subnigricans; Marasmius oreades; Podostroma cornu-damae; Pleurotus ostreatus; Inocybe; Clitocybe; Paxillus; Coprinopsis; Coprinus; Psilocybe; Panaeolus; Conocybe; Pluteus; Stropharia; Toxinas; Tratamento 1. Introducción nérgico. Micetismo por compuestos isoxazólicos o síndrome pantherina/muscaria. En esta Parte 4 de la serie de cuatro artículos sobre 5 Toxíndrome coprínico o cardiovascular. Micetismo micetismos (1-3) se analizan los síndromes tempranos inducido por alcohol o reacción tipo disulfiram. con sintomatología compleja, ya que los toxíndromes 6) Toxíndrome neurotóxico alucinogénico. Micetis- gastrointestinales o resinoides se han tratado en la par- mo por psilocibina y derivados indólicos. te 3 de esta serie de artículos. 7) Toxíndrome psicotrópico por estirilpironas y gim- El grupo 3, Parte 4, comprende los siguientes mice- nopilinas. Micetismo debido al hongo alucinogé- tismos tempranos: nico Gymnopilus spectabilis o Gymnopilus junonius. 1) Toxíndrome muscarínico o colinérgico periférico. 8) Toxíndrome agudo de rabdomiólisis. Micetismo Micetismo por especies de Inocybe y Clitocybe. por Russula subnigricans. 2) Toxíndrome inmunohemolítico o hemolítico. Mi- 9) Toxíndrome cianogénico. Micetismo por Maras- cetismo por Paxillus. mius oreades. 3) Toxíndrome neumónico alérgico. Licoperdonosis 10) Toxíndrome inmunosupresor. Micetismo por tri- o micetismo por Lycoperdon perlatum y por Pholiota cotecenos macrocíclicos de Podostroma cornu-damae. nameko. 11) Toxíndrome hemolítico debido a ostreolisina de 4) Toxíndrome panterínico o neurotóxico glutami- Pleurotus ostreatus y especies relacionadas. Acta Bioquím Clín Latinoam 2019; 53 (3): 361-96 Micetismos. Síndromes tempranos con síntomas complejos 363 2. Análisis de cada síndrome Mecanismo de acción. La muscarina es estructu- ralmente similar a la acetilcolina y causa toxicidad al del micetismo principal considerado unirse a las neuronas colinérgicas posganglionares en el sistema nervioso autónomo. La muscarina no puede Grupo 3, Parte 4: Micetismos tempranos con estimular a los receptores colinérgicos nicotínicos ni síntomas complejos cruzar la barrera hematoencefálica para causar un sín- drome colinérgico central (4). 2.1. Toxíndrome muscarínico
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