Kumm., Macrolepiota procera, Imleria badia or Suillus luteus (L.) Roussel), were a more common cause of such gastrointestinal events reported to the toxicological unit. Learn more. Working off-campus? The latter can be expected, and the fate of potential co‐consumers may be an informative clue when establishing to what extent individual susceptibility is involved in the development of clinical symptoms. (2001) on an outbreak of cases of rhabdomyolysis following T. equestre consumption, not a single study had evaluated the toxicity of this species, considered traditionally as edible, in any experimental model. It appears that T. equestre may not cause a similar effect, although considering the presence of individual differences in statin sensitivity among the human population, some caution is necessary when formulating such a conclusion. Such consumption by a human is virtually impossible. Based on available data, it is suggested that T. equestre cannot be considered as a toxic species and does not appear to exhibit any greater health threat than other mushroom species currently considered as edible. pallidifolia (or T. joachimii) is a representative of other species not belonging to the T. equestre species complex while T. equestre var. (2001) and Nieminen et al. One should note, however, that distinction of Tricholoma species based on spore morphology, particularly isolated from such material, is very difficult if even possible at all (see ‘Similar species’ section for more details). equestreas a poisonous species (Bedry & Gromb, 2009) (Figure 1). In the severe case, fatigue, nausea without vomiting and muscle pain, profuse sweating without fever, and respiratory insufficiency occurred. Following reports of cases of intoxication involving effects such as rhabdomyolysis, and supportive observations from in vivo experimental models, T. equestre is considered as a poisonous mushroom in some countries while in others it is still widely collected from the wild and consumed every year. Tricholoma flavovirens) is also known as the Man on Horseback; why that should be is a mystery. Live Statistics. There was no statistically significant increase in concentration of serum creatine kinase, aspartate and alanine aminotransferase in any studied individual 3 to 6 days after the last mushroom meal. Statins themselves can cause rhabdomyolysis although it is more commonly reported when statins are used in conjunction with other drugs, which can potentiate an effect (Mendes et al., 2014; Thompson, Clarkson, & Karas, 2003). of Joensuu, Finland. The yellow tricholoma (T. equestre or T. flavovirens) was previously consumed and marketed in several European countries. Firstly, the doses at which significant effects were detectable (mostly by increased creatine kinase concentration) were extremely high. (2008). This information is relevant if one considers that in all cases mushrooms were consumed as at least three consecutive meals (in other words, consumption over at least 3 days can be expected) while inappropriate storage (for example, prolonged room temperature, repeated freezing and thawing) may affect mushroom quality (Burton & Noble, 1993; Venturini, Reyes, Rivera, Oria, & Blanco, 2011). However, instead of questioning the general safety of these mushrooms, authors have fairly suggested that individual sensitivity could play a role in the development of such symptoms, and that rhabdomyolysis may represent an unspecified reaction, unrelated to specific mushroom species. The basic mechanism of poisoning is suspected to be rhabdomyolysis, damaging of the cell membrane of skeletal muscle fibres. Particular care should be taken when reporting cases of poisoning with T. equestre to avoid hype and mis‐ or overinterpretation of data. have all increased plasma creatine kinase activity in mice at 9 g/kg bw/day administered over 5 consecutive days to levels comparable to that observed in animals treated with similar doses of T. equestre (Nieminen et al., 2005, 2006; Nieminen, Kärjä, & Mustonen, 2009b). In other words, BALB/c mice may be less responsive to myotoxic agents than other laboratory strains. A study using an artificial gastric fluid system has demonstrated a high bioavailability of Ca, Cu, and Mg from T. equestre fruiting bodies (Kała et al., 2017). The stipe is usually yellow to yellow‐green 3 to 10 cm long, with an even diameter. populinum (Christensen & Noordeloos), associated with a deciduous habitat represented by Populus sp. Moreover, at lower but still relatively high doses (up to nearly 3 kg eaten every day) no significant effects were recorded in mice (Nieminen et al., 2005, 2008). The most poisonous species include those producing amatoxin peptides (with α‐amanitin revealing the greatest toxicity) such as Amanita phalloides (Vaill. [Rhabdomyolysis as an unspecyfic symptom of mushroom poisoning--a case report]. Spores are white, elliptical, 5 to 8.5 × 3 to 6 μm. Rhabdomyolysis induced by edible mushrooms is a reaction related to as yet unidentified genetic traits. In profuse sweating without fever, and respiratory insufficiency oc-curred. A significant increase in serum creatine kinase concentration was noted after 96 hr from last dosage in groups treated with boiled and chloroform‐methanol lipid free extracts of T. equestre—it amounted to 912 ± 425 and 883 ± 500 U/L, respectively, but was at least two‐fold lower than levels observed for the group treated with p‐phenylenediamine (1828±450 U/L) (Bedry et al., 2001). Quél., Lactarius deliciosus (L.) Gray and Boletus fragrans (Lanmaoa fragrans) Vittad. No significant change in any parameter was observed (Nieminen et al., 2005). Moreover, facial erythema, nausea, profuse sweating and hyperpnea was noted for selected patients. Animal toxicity study of Tricholoma equestre mushrooms stored for 12 months at (-)20 degrees C was performed using 30 male BALB/c mice. In 2001, Bedry et al. Nevertheless, this is highly dependent on environmental quality and can vary between species (Kalač, 2013; Mleczek et al., 2016a). (2001) who performed gavage administration, this study used mushrooms mixed into the feed of the animals. More care should be taken when reporting cases of human poisoning to fully identify T. equestre as the causative agent and to exclude a number of interfering factors. S. Lundell (see Deng and Yao, 2005) (2001) ruled out the presence of any etiological factors of rhabdomyolysis in intoxicated patients (substance abuse, use of selected medications, occurrence of selected virus infections and parasites, and active systemic disorder), a number of unanswered questions remained. trees, and T. equestre var. An interesting in vitro model that could be employed for such a purpose is the use of human skeletal muscle cells isolated from the skeletal muscle of limbs of healthy adults. The specimens for investigation were collected in mixed Picea and deciduous forest in Finland, from a location far from heavy road traffic or industrial activities. Erythorocyturia, leukocytosis. As noted by Nieminen, Mustonen, Kirsi, and Kärjä (2009a) in the brief summary on their in vivo studies, even in the group treated with the highest dose (12 g/kg bw/day for 28 days), some animals revealed unelevated creatine kinase concentration. In this particular case of poisoning, it appears that T. equestre consumption could be a triggering factor (Horn et al., 2005). As found, creatine kinase and aminotransferase concentrations were significantly increased, so were myoglobin levels. It is also unknown whether the possibility of a mushroom being wrongly identified was ruled out. (2005) who monitored biochemical parameters in 56 subjects (30 females, 26 male) aged 18 and 76 years old voluntarily consuming T. equestre as a single meal of 70 and 150 g of fresh mushrooms (n = 43) or for 4 consecutive days at a total dose ranging from 300 and 1200 g. Over half (57.1%) of the investigated subjects suffered from type 2 diabetes, 48.2% took statins (simvastatin, lovastatin, fluvastatin, and atorvastatin) and 12.5% were using fibrates (enofibrate, ciprofibrate) to treat hyperlipidemia. Adult male Swiss mice (each group n = 3) were given a powder of freeze‐dried fresh T. equestre for 3 days by gastric intubation in three doses: 2, 4, and 6 g/kg body weight (bw). Use the link below to share a full-text version of this article with your friends and colleagues. Although the report of Bedry et al. populinum, associated with deciduous trees, are representatives of the T. frondosae clade not the T. equestre group (which is associated with coniferous habitats). edibility: not recommended Tricholoma equestre or Tricholoma flavovirens, also known as man on horseback or yellow knight is a formerly widely eaten but hazardous fungus of the genus Tricholoma that forms ectomycorrhiza with pine trees. Caps of young specimens are sticky, and usually dry when matured. and you may need to create a new Wiley Online Library account. Information on sites of mushroom collection, conditions of storage during period of consumption and form in which they were prepared for consumption is also essentially lacking. These cells can now be commercially purchased from certified suppliers and cultured for at least 15 doublings. Mineral Composition of Three Popular Wild Mushrooms from Poland. Three cases had a fatal outcome. All animals survived the experiment. Tricholoma equestre or Tricholoma flavovirens, also known as Man on horseback or Yellow knight is a formerly widely eaten but hazardous fungus of the Tricholoma genus that forms ectomycorrhiza with pine trees.. Developments in Plant and Soil Sciences, Chemical composition and nutritional value of three Tunisian wild edible mushrooms, Kinetics of extracted bioactive components from mushrooms in artificial digestive juices, Chemical composition and nutritional value of European species of wild growing mushrooms: A review, A review of chemical composition and nutritional value of wild‐growing and cultivated mushrooms, A review of trace element concentrations in edible mushrooms, Taxonomy and ecology of the species of the, Vitamin content in mushrooms. ex Fr.) Poland, Cadmium in mushrooms at selected positions in Poland. Similarly to other poisoning cases associated with T. equestre and involving rhabdomyolysis, no renal insufficiency was noted. (2004) did not find any effects of powder/extracts made from T. equestre in BALB/c mice. Due to its distinctively different morphological features, there is a lower chance of mistaking T. equestre for other gilled mushroom species with green or yellow green caps and/or stipe such as Rusulla aurea Pers., R. clavoflava Grove, young specimens of Amanita phalloides (Vaill. It is a mycorrhizal mushroom associated particularly with coniferous tree species (mainly Pinus rarely Abies and Picea), and often associated with nutrient‐ and humus‐poor sandy soils. A 71‐old‐year man was admitted to hospital after he consumed a mushroom meal twice a day for 6 consecutive days and observed muscle weakness and myalgia. The flavomannin‐6,6‐dimethylether, a polyphenol with a dimeric pre‐anthraquinone structure that is thought to be a mushroom yellow pigment, has been isolated and purified from cooked fruiting bodies, and further demonstrated to exhibit in vitro cytostatic effects in human adenocarcinoma colorectal Caco‐2 cells by inducing cell‐cycle arrest without genotoxic activity (Pachón‐Peña et al., 2009; Steglich et al., 1972). A total of 21 cases which involved rhabdomyolysis (without renal injury) have been documented. It remains to be studied whether and how rapidly potentially toxinogenic mold species can colonize dead fruiting bodies of T. equestre. Multiannual monitoring (1974–2019) of rare earth elements in wild growing edible mushroom species in Polish forests. The reported cases deliver no information on the habitat from which the mushrooms were collected. These observations were also supported by in vivo rodent experiments involving 3‐day exposure to powdered or extracted fruiting bodies of T. equestre that reported an increase in serum creatine kinase and disorganization of muscle fibers. Singer (Falandysz et al., 2017). A larger study was conducted by Chodorowski et al. Known as Grünling in German, gąska zielonka in Polish, and canari in French, it has been treasured as an edible mushroom worldwide and is especially abundant in France. Moreover, compared to other mushrooms, T. equestre can be a rich source of β‐carotene, particularly in its caps. Go to: 1. The effect of different substrates on the growth of six cultivated mushroom species and composition of macro and trace elements in their fruiting bodies, https://doi.org/10.1007/s00244-002-2051-0, https://doi.org/10.1007/s13225-011-0116-y, https://doi.org/10.1016/j.revmed.2009.03.017, https://doi.org/10.1161/01.CIR.0000131519.15067.1f, https://doi.org/10.1016/0925-5214(93)90025-X, https://doi.org/10.1007/s12011-010-8853-4, https://doi.org/10.1016/j.talanta.2013.09.038, https://doi.org/10.1007/s13225-013-0260-7, https://doi.org/10.1111/j.1574-6941.2010.00983.x, https://doi.org/10.1007/s00253-012-4552-8, https://doi.org/10.1016/j.foodchem.2016.10.047, https://doi.org/10.1007/s13659-015-0071-5, https://doi.org/10.1016/j.jhazmat.2009.01.058, https://doi.org/10.1007/978-94-017-1284-2_4, https://doi.org/10.1007/s11694-017-9590-6, https://doi.org/10.1080/10942912.2016.1219742, https://doi.org/10.1016/j.foodchem.2008.07.077, https://doi.org/10.1016/S0308-8146(99)00264-2, https://doi.org/10.1016/S0733-8627(05)70186-3, https://doi.org/10.1186/s13002-016-0117-8, https://doi.org/10.6001/actamedica.v23i3.3385, https://doi.org/10.1007/s00128-012-0757-x, https://doi.org/10.1109/RSETE.2011.5966264, https://doi.org/10.1016/j.scitotenv.2009.07.001, https://doi.org/10.1016/j.fct.2015.12.002, https://doi.org/10.1007/s11356-016-6760-8, https://doi.org/10.1080/19440049.2015.1114684, https://doi.org/10.1016/j.jfca.2017.12.018, https://doi.org/10.1007/s13225-012-0196-3, https://doi.org/10.1016/j.funbio.2013.01.003, https://doi.org/10.1016/j.fct.2007.10.014, https://doi.org/10.1016/j.fct.2008.10.009, https://doi.org/10.1177/153537020623100213, https://doi.org/10.1016/j.fct.2004.09.002, https://doi.org/10.3358/shokueishi.58.132, https://doi.org/10.1371/journal.pone.0190948, https://doi.org/10.1016/j.bbrc.2015.09.065, https://doi.org/10.1016/j.tox.2009.08.009, https://doi.org/10.1016/j.envres.2015.06.039, https://doi.org/10.1371/journal.pone.0063926, https://doi.org/10.1016/S0378-1127(01)00543-6, https://doi.org/10.1007/s11356-017-0359-6, https://doi.org/10.1007/s40726-016-0026-4, https://doi.org/10.1016/j.phanu.2017.02.001, https://doi.org/10.1016/j.tifs.2017.05.010, https://doi.org/10.1016/j.microc.2009.04.005, https://doi.org/10.1016/j.jfca.2016.06.009, https://doi.org/10.1016/j.jfca.2017.02.011, https://doi.org/10.1007/s12161-016-0608-1, https://doi.org/10.1016/j.ejps.2007.12.009, https://doi.org/10.1016/j.nmd.2011.10.011, https://doi.org/10.1016/S0041-0101(97)00074-3, https://doi.org/10.1016/j.foodchem.2006.07.041, https://doi.org/10.1080/03067319708031393, Leg muscle weakness and myalgia, fatigue, facial erythema, profuse sweating. Nieminen et al., 2005 recruited four healthy volunteers who consumed a single portion of 150 mg of dried T. equestre per kg bw, an equivalent to approximately 100 g of fresh mushrooms consumed by a 70 kg adult. All animals remained in good health. The color of fruiting bodies is bright yellow to yellow‐green when immature, often with a brownish umbo. Patients may present with muscle pain and have been reported with elevated creatinine phosphokinase levels, in the 10,000 U/L to 100,000 U/L range. This case is the only one of all in documented T. equestre poisonings in which concentration of MB isoform of creatine kinase, a cardiac marker expressed mostly in the myocardium (Karras & Kane, 2001), was reported additionally to total creatine kinase level (Anand, Chwaluk, & Sut, 2009; Chodorowski, Waldman, & Sein Anand, 2002). Considering the available and growing evidence of the toxicity of T. equestre, a number of countries have officially registered T. equestre as a poisonous species (Bedry & Gromb, 2009) (Figure 1). Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Kumm., Der Führer in die Pilzkunde: 130 (1871) [MB#176119] Individuals with a fatal outcome also developed dyspnea, acute myocarditis (arrhythmia, cardiovascular collapse, and wide QRS complex) and hyperthermia. (2004) on male BALB/c mice (n = 5 in each group) did not find any significant effect of freeze‐dried powder of T. equestre nor its boiled aqueous and chloroform‐methanol extracts (all given by gavage at dose of 12g/kg bw/day for 3 days) on serum creatine kinase concentration measured 72 hr after a final dose (157 ± 93, 129 ± 30, and 96 ± 38 U/L, respectively, compared to 107 ± 38 U/L in control). The juxtaposition of expected mean content in a standard serving of selected metals in T. equestre which are known to exert toxic effects at certain exposure levels (calculated on values given in Table 1) with established values of the Provisional Tolerable Weekly Intake (PTWI), Provisional Maximum Tolerable Daily Intake (PMTDI), Tolerable Daily Intake (TDI) or oral Permitted Daily Exposure (PDE) is presented in Table 2. Kumm., Tricholoma portentosum (Fr.) None of these cases were characterized by altered biochemical parameters (including creatine kinase activity) and no rhabdomyolysis was observed. The yellow tricholoma (Tricholoma flavovirensor Tricholoma equestre) is a wild mushroom species that was previously considered edible and tasty. All (or most) edible mushrooms can induce rhabdomyolysis in humans at high and repeated doses. T. flavovirens, (Peerson), and syn. Considering that the extensive consumption of any food has its own risks, we question whether the in vivo findings are meaningful enough to classify any of abovementioned mushrooms, including T. equestre, as inedible or even potentially toxic. This is the only case report in which interactions between mushrooms and statins can be suspected, yet its exact mechanisms remain unknown. In the second study, Nieminen et al. It is unknown if mushrooms were stored before consumption, and if so—under which conditions. Mean serum creatine kinase activity in p-phenylenediamine group (265 +/- 63 U/L) was significantly higher than in group treated with water (p<0.01). Muscle weakness and myalgia, profuse sweating without fever, fatigue. Tricholoma equestre (L.) P. Such a model allows an assessment of the potential effect of mushroom extracts on the cellular ultrastructural morphology of cells and creatine kinase activities, and appears to be relevant in identification of compound potency to induce rhabdomyolysis in humans. Phylogenetic analyses of ITS patterns indicate that T. equestre represents a species complex which still remains poorly resolved (Heilmann‐Clausen, Christensen, Frøslev, & Kjøller, 2017). Rzymski P, Klimaszyk P (2018) Is the yellow knight’s mushroom edible or not? As self‐reported, the patient had often consumed large quantities of T. equestre in the past without any noticeable adverse effects.