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Intoxication par Amanita proxima: une nouvelle cause d'insuffisance rénale aigue
Report
and
i-o.~-i?~,s of Burkhoideria pseudomallel vzo,~ hc ~,e.c/,o/l.crh/r~.for B. Currie (Menzies School of Health Researszh. P.0. Box
Abstracts
WY
f;rt~r/ ~~~~1zoido.\~.s. A. Haase, J. Janzen. 41096. Casuarina. NT 081 I. Australia).
S. Barrett
and
Melioidosis is a potentially fatal djsease caused l-11 the so11 bacterium Bwkhokierirr pseudo~vtrlk~i (formerly Pscurionronu,v psc&r~mtr/lri). The disease is endemic in south-east Asia and tropical Australia and most incidences occur during the wet season. The most common clinical presentation is pneumonia but any organ can be affected with multiple abscesses. A characteristic is the very rapid onset of the disease that frequently requires the patient to be treated in intensive care. In severe cases of scpticaemia death can occur within 24.-48 hr of the onset of symptoms. We have purified two exotoxins of B. /~\cllik)lj~rr//~i: a cytolethal. fast-acting peptlde and a slam-acting protein toxin. They have been structurally and h~olog~cally characterized.
A wiwolo.vic’ ~~lro\/~l~oli/~~~.~i~ Ar in !/x, I~CV~O~I~of rllcz CO,,I,!,OI, tikw~h &&r. L. \an der Weyden and K. W Broady (Immunobiology Umt. llnlverslty St. Gore Hill. Austraha. 2065).
Acanthophis antarctlcuh. of Technology. Sydne).
P. G. Hains. Westbourne
The venom of the common death ,Idder. .4~cr/1r/v~/>hi\ CI~I~C~~C ii I,.\. IF reported to contain only 17(~stsyn;lptlc;llly acting neurotoxms. Recent findings revealed the lprevznce of phospholipase A, enzymes In the venom. Whole venom was fractionated on a Mono-S column and hevera phosphohpase A: enzymes were vzparatcd. The mgjority of phospholipase A: activity was present in peak 2, cluting at a \alt concentrat]on of 0.3 M. This phospholipase A? enzyme. termed acanthoxin. \h,ts further purified by a second elutlon through the hlono-S column. and final purity was assured by rever\e-phase high-perlirrnl:ince liquid chromatography. Rcanthoxin i\ believed to exist as a homodimer of approximately .X).1)00 mol. wt. The enzyme ha> a high etvymatic activity on mlcellar substrate (using the method of Rad\anyi (‘I (I/.. 1989). in the absence of dctcrgentq. AcanthoGr ha5 been shown to be lethal v,hen lniccted S.C. in mice. with cl,lssical presynaptic s>mptoma preceding death. Total amino acid analysis ha% been perlhrmcd on th< pul-ificd cnlymc. ;tnti homology (in terms of .un1no acid content) i\ prccent with other snake \cnom pho this snake ;,nd the clinical 41.g~ ohscrvetl after cn\enomatlon
.IC,IIIC ~~,nr~l fuiiuw II~IC 10 Amanita proxlma: CI,XV’,CV,C c of th(, Alo,.\c,i//c~c I’O~.\CJII C’e~~/rc. L. de Harcr. J. Ardltti.’ J.-M. David.’ J.-M. Raacol’ and J Jougl:ud (‘Centrc 4nti-Poisons. 1lOpitai Sal\atol . 230 Bcl Sainte Margucrlte. 13 009 Marseille: ,md ‘Lahoratolre dc Botaniquc et C‘r>ptog,unie. F,lcultt: de Pharmacie dc Marselllc. France). In southern France. some A/~~o,ri!~r species are frequently catzn. This IS the cam with ,-l/jl~/ii/(/ or-oi&v (Q&let. I571) which is a \‘ery common white mushroom. In some area‘,. a ccrl similar and less common fungus can he encountcrcd: .3rucl//ii~i pr~~.riuu (Dumee. 19 16). The first published cases 01‘ A. ,vo\-/r?,rr poisclning were reported 111 IVY4 by a medical team from Montpcllier I:Leray c’/ ~rl.. 1004). five patients pre\ented af.er d meal with this funpus had early tllgeativc disorders. cytol>tlc hepatitis and acute renal failure. A \ccond arttcle ua< published 11, lYY5 by physiclana from M:lrseille< (Duct-oa (‘I (rl.. IYYS), ;tgain involving renal and hepatlc disturbance<. In (order to evaluate the tmportance of the confusion hctwern thL, two specIea. u’e investigated itlformatlon on these mubh1-oom polsonlngs. collected by lhc Pol\on C‘entrc of Marseilles. There were 20 cases cotvzerning 4Y patients (ten collective cases). ‘The lirst lntoxic.ltion was obscrvcd tn IVO., hut cases ,cem to hc more nlmcrou, since IYXO. Poisomngs took place 111all parts of I’rovcnce. Ingestion m 24 cavz\ (X3’!<, of the 1Y casca) ohiis due to confurioll with 1. r~c,~>/&c/ (patients were certain that they had caten a meal ol’cdiblc fungi). Patients did not know v+hat they had c,ltell in live casts only (I 7”~)): ho\%ej,er. ~gnorancc reprehcnth the moht common circumstance 111other case\ ol’ mushroom poisoning. The tlelaq between ~hc meal and the first <~gni marled grearlj: 1 4X hr (average 13 hr and 33 min). All patlcnts had e;lstrointe\till;ll symptoms (ahdomlnal pain. vomiting and tJl+rl-hoe,l). ;ind in 14 of them oliguria or anurj:i appeal-cd Lvithin of stmptoms was dose dependent: C;~XS wcrc collected 11, the same family. which Included with no vgn\ ;:liet justvtastlngthe meal. dlgrsti\e rymptoms onI> uhen patientz ate more. :~nd trenal lililurc 111people who con\umed ii large amount of the mushroom
and
i-o.~-i?~,s of Burkhoideria pseudomallel vzo,~ hc ~,e.c/,o/l.crh/r~.for B. Currie (Menzies School of Health Researszh. P.0. Box
Abstracts
WY
f;rt~r/ ~~~~1zoido.\~.s. A. Haase, J. Janzen. 41096. Casuarina. NT 081 I. Australia).
S. Barrett
and
Melioidosis is a potentially fatal djsease caused l-11 the so11 bacterium Bwkhokierirr pseudo~vtrlk~i (formerly Pscurionronu,v psc&r~mtr/lri). The disease is endemic in south-east Asia and tropical Australia and most incidences occur during the wet season. The most common clinical presentation is pneumonia but any organ can be affected with multiple abscesses. A characteristic is the very rapid onset of the disease that frequently requires the patient to be treated in intensive care. In severe cases of scpticaemia death can occur within 24.-48 hr of the onset of symptoms. We have purified two exotoxins of B. /~\cllik)lj~rr//~i: a cytolethal. fast-acting peptlde and a slam-acting protein toxin. They have been structurally and h~olog~cally characterized.
A wiwolo.vic’ ~~lro\/~l~oli/~~~.~i~ Ar in !/x, I~CV~O~I~of rllcz CO,,I,!,OI, tikw~h &&r. L. \an der Weyden and K. W Broady (Immunobiology Umt. llnlverslty St. Gore Hill. Austraha. 2065).
Acanthophis antarctlcuh. of Technology. Sydne).
P. G. Hains. Westbourne
The venom of the common death ,Idder. .4~cr/1r/v~/>hi\ CI~I~C~~C ii I,.\. IF reported to contain only 17(~stsyn;lptlc;llly acting neurotoxms. Recent findings revealed the lprevznce of phospholipase A, enzymes In the venom. Whole venom was fractionated on a Mono-S column and hevera phosphohpase A: enzymes were vzparatcd. The mgjority of phospholipase A: activity was present in peak 2, cluting at a \alt concentrat]on of 0.3 M. This phospholipase A? enzyme. termed acanthoxin. \h,ts further purified by a second elutlon through the hlono-S column. and final purity was assured by rever\e-phase high-perlirrnl:ince liquid chromatography. Rcanthoxin i\ believed to exist as a homodimer of approximately .X).1)00 mol. wt. The enzyme ha> a high etvymatic activity on mlcellar substrate (using the method of Rad\anyi (‘I (I/.. 1989). in the absence of dctcrgentq. AcanthoGr ha5 been shown to be lethal v,hen lniccted S.C. in mice. with cl,lssical presynaptic s>mptoma preceding death. Total amino acid analysis ha% been perlhrmcd on th< pul-ificd cnlymc. ;tnti homology (in terms of .un1no acid content) i\ prccent with other snake \cnom pho
.IC,IIIC ~~,nr~l fuiiuw II~IC 10 Amanita proxlma: CI,XV’,CV,C c of th(, Alo,.\c,i//c~c I’O~.\CJII C’e~~/rc. L. de Harcr. J. Ardltti.’ J.-M. David.’ J.-M. Raacol’ and J Jougl:ud (‘Centrc 4nti-Poisons. 1lOpitai Sal\atol . 230 Bcl Sainte Margucrlte. 13 009 Marseille: ,md ‘Lahoratolre dc Botaniquc et C‘r>ptog,unie. F,lcultt: de Pharmacie dc Marselllc. France). In southern France. some A/~~o,ri!~r species are frequently catzn. This IS the cam with ,-l/jl~/ii/(/ or-oi&v (Q&let. I571) which is a \‘ery common white mushroom. In some area‘,. a ccrl similar and less common fungus can he encountcrcd: .3rucl//ii~i pr~~.riuu (Dumee. 19 16). The first published cases 01‘ A. ,vo\-/r?,rr poisclning were reported 111 IVY4 by a medical team from Montpcllier I:Leray c’/ ~rl.. 1004). five patients pre\ented af.er d meal with this funpus had early tllgeativc disorders. cytol>tlc hepatitis and acute renal failure. A \ccond arttcle ua< published 11, lYY5 by physiclana from M:lrseille< (Duct-oa (‘I (rl.. IYYS), ;tgain involving renal and hepatlc disturbance<. In (order to evaluate the tmportance of the confusion hctwern thL, two specIea. u’e investigated itlformatlon on these mubh1-oom polsonlngs. collected by lhc Pol\on C‘entrc of Marseilles. There were 20 cases cotvzerning 4Y patients (ten collective cases). ‘The lirst lntoxic.ltion was obscrvcd tn IVO., hut cases ,cem to hc more nlmcrou, since IYXO. Poisomngs took place 111all parts of I’rovcnce. Ingestion m 24 cavz\ (X3’!<, of the 1Y casca) ohiis due to confurioll with 1. r~c,~>/&c/ (patients were certain that they had caten a meal ol’cdiblc fungi). Patients did not know v+hat they had c,ltell in live casts only (I 7”~)): ho\%ej,er. ~gnorancc reprehcnth the moht common circumstance 111other case\ ol’ mushroom poisoning. The tlelaq between ~hc meal and the first <~gni marled grearlj: 1 4X hr (average 13 hr and 33 min). All patlcnts had e;lstrointe\till;ll symptoms (ahdomlnal pain. vomiting and tJl+rl-hoe,l). ;ind in 14 of them oliguria or anurj:i appeal-cd Lvithin of stmptoms was dose dependent: C;~XS wcrc collected 11, the same family. which Included with no vgn\ ;:liet justvtastlngthe meal. dlgrsti\e rymptoms onI> uhen patientz ate more. :~nd trenal lililurc 111people who con\umed ii large amount of the mushroom