Hemolysis associated with Russula subnigricans ingestion in a patient with glucose-6-phosphate dehydrogenase deficiency

Abstract

Introduction

Russula subnigricans is now one of the leading lethal mushroom species in China, with a mortality rate of more than 50%. The typical clinical manifestation of Russula subnigricans poisoning is rhabdomyolysis, and we are unaware of previous reports of Russula subnigricans-associated hemolysis.

Case series

Herein we report a cluster of five patients with confirmed Russula subnigricans poisoning. Four of the patients who ingested sun-dried Russula subnigricans never developed rhabdomyolysis. However, in one patient, acute hemolysis developed on the second day following ingestion and was associated with a fall in hemoglobin concentration and a rise in unconjugated bilirubin concentration. Further investigation revealed that the patient had glucose-6-phosphate dehydrogenase deficiency.

Conclusion

This case cluster suggests that the toxin of Russula subnigricans could cause hemolysis in a susceptible patient and warrants further study.

Keywords:

• Russula subnigricans
• Hemolysis
• G6PD deficiency
• Rhabdomyolysis

Author contributions

The manuscript writing and patients data recording were done by Yuting Pu. Feichi Wang assisted in information collection. Hongliang Zhang, Xiangping Chai provided writing guidance, Bing Xiao reviewed the manuscript. The final manuscript was read and ratified by all authors.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by Natural Science Foundation of Hunan Province [No. 2021JJ40879] and Science Project of Hunan Health Commission [No. 202203022422].