Question: What is the Paxillus Involutus Immunohemolytic Syndrome?
Answer: The cited reference notes: “The Paxillus syndrome is a rare, and potentially fatal, immunoallergic reaction that may follow the consumption of many common, but inedible, mushroom species, including Paxillus involutus (Poison Pax) and possibly Boletus luridus (Stem Net Bolete) and Clitocybe clavi- ceps (Alcohol Funnel Cap). The Paxillus syndrome occurs most commonly after the repeated ingestion of Paxillus involutus and is characterized by an acute onset of nausea, vomiting, epigastric pain, and diarrhea within 30 mins to 3 hours of ingestion. An acute immune complex-mediated hemolytic anemia with hemoglobinuria, oliguria, anuria, and acute renal failure from immune-complex nephritis may follow, possibly initiated by an allergic response to a common Paxillus and Boletus antigenic protein constituent, involutin.” (Diaz J, Syndromic diagnosis and management of confirmed mushroom poisonings. 2005 Crit Care Med 33:427-436)