Anaphylactoid reactions to acetylcysteine treatment in wild mushroom poisoning patients in Yunnan, China.

The Affiliated Hospital of Yunnan University, which serves as the primary treatment center for poisoning cases in Yunnan Province, conducted a retrospective cohort study to investigate the incidence of anaphylactoid reactions in patients with wild mushroom poisoning who received intravenous acetylcysteine. The study, which spanned from January 1, 2023, to August 31, 2024, included 110 patients, with 20 of them having been admitted for wild mushroom poisoning and the remaining 90 for other conditions. The primary objective of the study was to determine the occurrence of anaphylactoid reactions in patients who received acetylcysteine, with a particular focus on those with wild mushroom poisoning. The findings of the study revealed a significantly higher risk of anaphylactoid reactions in patients with wild mushroom poisoning, with an odds ratio (OR) of 5.43. The symptoms of these reactions were typically mild, and further analysis identified female gender and a history of allergies as independent risk factors, with ORs of 3.49 and 3.82, respectively. A predictive model combining these factors showed good performance, with an area under the receiver operating characteristic curve of 0.88. The study suggests that the higher bioavailability of trace mineral elements in wild mushrooms, which are not fully cooked, may contribute to the increased risk of anaphylactoid reactions in patients with wild mushroom poisoning who receive acetylcysteine. Specifically, the accumulated mineral elements in these patients may bind with acetylcysteine, forming substances that trigger anaphylactoid reactions. Overall, the study highlights the need for caution when administering acetylcysteine to patients with wild mushroom poisoning, particularly those with a history of allergies or female patients, and underscores the importance of monitoring for potential anaphylactoid reactions in this population. Link: https://pubmed.ncbi.nlm.nih.gov/40462751/