A case report of acute liver failure caused by Gyromitra venenata poisoning and a literature review.

This report describes a case of acute liver failure in Guizhou Province, China, caused by the accidental ingestion of poisonous wild mushrooms. The patient developed symptoms after consuming approximately 500 grams of wild mushrooms he had gathered himself. The incubation period was approximately 18 h, and 36 h after ingestion, the patient developed severe gastrointestinal symptoms (hematemesis, melena, and abdominal pain) as well as progressive liver damage. Laboratory tests revealed significantly elevated transaminases and coagulation disorders, consistent with the clinical presentation of toxin-induced acute liver failure accompanied by severe gastrointestinal haemorrhage. Through retrospective epidemiological investigation and molecular biological testing, the suspected mushroom was identified as Gyromitra venenata. Screening for 13 common mushroom toxins using UPLC-MS/MS yielded negative results. This case report provides the first detailed documentation of clinical data regarding Gyromitra venenata poisoning. It clearly highlights that, in addition to the neuropsychiatric and haemolytic forms, greater attention should be paid to the clinical features of acute liver injury caused by Gyromitra venenata poisoning. This case report provides important guidance for the future management of poisoning from this species.