HOME

TheInfoList



OR:

''Gyromitra esculenta'' is an ascomycete fungus from the genus ''
Gyromitra ''Gyromitra'' () is a genus of about 18 species of ascomycete fungi. They are a false morel - a frequently toxic mushroom that can be mistaken for edible mushrooms of the genus ''Morchella'' (morels). Taxonomy The name ''Gyromitra'' comes from ...
'', widely distributed across Europe and North America. It normally fruits in sandy soils under coniferous trees in spring and early summer. The
fruiting body The sporocarp (also known as fruiting body, fruit body or fruitbody) of fungi is a multicellular structure on which spore-producing structures, such as basidia or asci, are borne. The fruitbody is part of the sexual phase of a fungal life cy ...
, or mushroom, is an irregular brain-shaped
cap A cap is a flat headgear, usually with a visor. Caps have crowns that fit very close to the head. They made their first appearance as early as 3200 BC. Caps typically have a visor, or no brim at all. They are popular in casual and informal se ...
dark brown in colour that can reach high and wide, perched on a stout white stipe up to high. Although potentially fatal if eaten raw, ''Gyromitra esculenta'' is a popular delicacy in
Scandinavia Scandinavia; Sámi languages: /. ( ) is a subregion in Northern Europe, with strong historical, cultural, and linguistic ties between its constituent peoples. In English usage, ''Scandinavia'' most commonly refers to Denmark, Norway, and Swe ...
, Eastern Europe, and the upper
Great Lakes region The Great Lakes region of North America is a binational Canadian–American region that includes portions of the eight U.S. states of Illinois, Indiana, Michigan, Minnesota, New York, Ohio, Pennsylvania and Wisconsin along with the Canadian p ...
of
North America North America is a continent in the Northern Hemisphere and almost entirely within the Western Hemisphere. It is bordered to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the southeast by South America and the Car ...
. Although popular in some districts of the eastern
Pyrenees The Pyrenees (; es, Pirineos ; french: Pyrénées ; ca, Pirineu ; eu, Pirinioak ; oc, Pirenèus ; an, Pirineus) is a mountain range straddling the border of France and Spain. It extends nearly from its union with the Cantabrian Mountains to C ...
, it is prohibited from sale to the public in Spain. It may be sold fresh in
Finland Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of B ...
, but it must be accompanied by warnings and instructions on correct preparation. Although it is still commonly
parboil Parboiling (or leaching) is the partial or semi boiling of food as the first step in cooking. The word is from the Old French 'parboillir' (to boil thoroughly) but by mistaken association with 'part' it has acquired its current meaning. The wo ...
ed before preparation, evidence suggests that even this procedure may not make ''Gyromitra esculenta'' entirely safe for consumption. When consumed, the principal active agent, gyromitrin, is hydrolyzed into the toxic compound
monomethylhydrazine Monomethylhydrazine (mono-methyl hydrazine, MMH) is a highly toxic, volatile hydrazine derivative with the chemical formula . It is used as a rocket propellant in bipropellant rocket engines because it is hypergolic with various oxidizers such as ...
(MMH), a type of rocket fuel. The toxin affects the liver,
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
, and sometimes the
kidneys The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; bloo ...
. Symptoms of poisoning involve vomiting and diarrhea several hours after consumption, followed by dizziness, lethargy and headache. Severe cases may lead to delirium, coma and death after five to seven days.


Taxonomy and naming

The fungus was first described in 1800, by mycologist
Christian Hendrik Persoon Christiaan Hendrik Persoon (1 February 1761 – 16 November 1836) was a German mycologist who made additions to Linnaeus' mushroom taxonomy. Early life Persoon was born in South Africa at the Cape of Good Hope, the third child of an i ...
, as ''Helvella esculenta'', and gained its current accepted binomial name when the Swedish mycologist Elias Magnus Fries placed it in the genus ''Gyromitra'' in 1849. The genus name is derived from the
Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...
terms ''gyros''/γυρος "round" and ''mitra''/μιτρα "headband". Its specific epithet is derived from the
Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
''esculentus'', "edible". It is known by a variety of common descriptive names such as "brain mushroom", "turban fungus", ''elephant ears'', or "beefsteak mushroom/morel", although ''beefsteak mushroom'' can also refer to the much less toxic basidiomycete ''
Fistulina hepatica ''Fistulina hepatica'' (beefsteak fungus, also known as beefsteak polypore, poor man’s steak, ox tongue, or tongue mushroom) is an unusual bracket fungus classified in the Agaricales, that is commonly seen in Britain, but can be found in Nor ...
''. Dating from the 19th century, the German term is a result of the older , itself from the 18th century
Low German : : : : : (70,000) (30,000) (8,000) , familycolor = Indo-European , fam2 = Germanic , fam3 = West Germanic , fam4 = North Sea Germanic , ancestor = Old Saxon , ancestor2 = Middle L ...
, aligning with the similar-sounding (and similar-looking) . ''Gyromitra esculenta'' is a member of a group of fungi known as "
false morel The name false morel is given to several species of mushroom which bear a resemblance to the highly regarded true morels of the genus ''Morchella''. Like ''Morchella'', false morels are members of the Pezizales, but within that group represent se ...
s", so named for their resemblance to the highly regarded true morels of the genus ''Morchella''. The grouping includes other species of the genus ''Gyromitra'', such as '' G. infula'' (elfin saddle), '' G. caroliniana'' and '' G. gigas'' (snow morel). While some of these species contain little to no gyromitrin, many guidebooks recommend treating them all as poisonous, since their similar appearance and significant intraspecific variation can make reliable identification difficult. The toxic qualities of ''G. esculenta'' may be reduced by cooking, but possibly not enough to prevent poisoning from repeated consumption. The more distantly related ascomycete mushrooms of the genus ''
Verpa ''Verpa'' is a genus of ascomycete fungi related to the morels. Resembling the latter genus in edibility and form, the common name early morels is popular. There are five species in the widespread genus. ''Verpa'' comes from the Latin for ''erec ...
'', such as '' V. bohemica'' and '' V. conica'', are also known as false morels, early morels or thimble morels; like the ''
Gyromitra ''Gyromitra'' () is a genus of about 18 species of ascomycete fungi. They are a false morel - a frequently toxic mushroom that can be mistaken for edible mushrooms of the genus ''Morchella'' (morels). Taxonomy The name ''Gyromitra'' comes from ...
'', they are eaten by some and considered poisonous by others. The genus ''Gyromitra'' had been classically considered part of the family Helvellaceae, along with the similar-looking elfin saddles of the genus '' Helvella''. Analysis of the
ribosomal Ribosomes ( ) are macromolecular machines, found within all cells, that perform biological protein synthesis (mRNA translation). Ribosomes link amino acids together in the order specified by the codons of messenger RNA (mRNA) molecules to for ...
DNA of many of the Pezizales showed ''Gyromitra esculenta'' and the other false morels to be only distantly related to the other members of the Helvellaceae and instead most closely related to the genus '' Discina'', forming a
clade A clade (), also known as a monophyletic group or natural group, is a group of organisms that are monophyletic – that is, composed of a common ancestor and all its lineal descendants – on a phylogenetic tree. Rather than the English term, ...
which also contains ''
Pseudorhizina ''Pseudorhizina'' is a genus of ascomycete fungi related to the false morels of the genus ''Gyromitra''. The type species In zoological nomenclature, a type species (''species typica'') is the species name with which the name of a genus or s ...
'' and ''
Hydnotrya ''Hydnotrya'' is a genus of ascomycete fungi related to the false morels of the genus ''Gyromitra''. There are about 15 species in the genus. A molecular phylogenetic study recovered a species that was described but neglected for 50 years, ''Hyd ...
''. Thus the four genera are now included in the family Discinaceae.


Description

Resembling a brain, the irregularly shaped
cap A cap is a flat headgear, usually with a visor. Caps have crowns that fit very close to the head. They made their first appearance as early as 3200 BC. Caps typically have a visor, or no brim at all. They are popular in casual and informal se ...
may be up to high and wide. Initially smooth, it becomes progressively more wrinkled as it grows and ages. The cap colour may be various shades of reddish-, chestnut-, purplish-, bay-, dark or sometimes golden-brown; it darkens to black in age. Specimens from California may have more reddish-brown caps. Attached to the cap at several points, the stipe is high and wide. ''Gyromitra esculenta'' has been reported to have a solid stipe whereas those of true morels ('' Morchella'' spp.) are hollow, although a modern source says it is hollow as well. The smell can be pleasant and has been described as fruity, and the fungus is mild-tasting. The spore print is whitish, with transparent spores that are elliptical and 17–22  μm in length.


Similar species

''Gyromitra esculenta'' resembles the various species of true morel, although the latter are more symmetric and look more like pitted gray, tan, or brown
sponge Sponges, the members of the phylum Porifera (; meaning 'pore bearer'), are a basal animal clade as a sister of the diploblasts. They are multicellular organisms that have bodies full of pores and channels allowing water to circulate throug ...
s. Its cap is generally darker and larger. ''Gyromitra gigas'', ''G. infula'' and '' G. ambigua'' in particular are similar. The latter two are toxic to humans.


Distribution and habitat

''Gyromitra esculenta'' grows on sandy soil in
Temperate coniferous forest Temperate coniferous forest is a terrestrial biome defined by the World Wide Fund for Nature. Temperate coniferous forests are found predominantly in areas with warm summers and cool winters, and vary in their kinds of plant life. In some, needle ...
and occasionally in deciduous woodlands. Among conifers it is mostly found under pines (''
Pinus A pine is any conifer tree or shrub in the genus ''Pinus'' () of the family Pinaceae. ''Pinus'' is the sole genus in the subfamily Pinoideae. The World Flora Online created by the Royal Botanic Gardens, Kew and Missouri Botanical Garden ...
'' spp.), but also sometimes under aspen ('' Populus'' spp.). The hunting period is from April to July, earlier than for other species, and the fungus may even sprout up with the melting snow. It can be abundant in some years and rare in others. The mushroom is more commonly found in places where ground has been disturbed, such as openings, rivulets, washes, timber clearings, plowed openings, forest fire clearings, and roadsides. Enthusiasts in Finland have been reported burying newspaper inoculated with the fungus in the ground in autumn and returning the following spring to collect mushrooms. Although more abundant in
montane Montane ecosystems are found on the slopes of mountains. The alpine climate in these regions strongly affects the ecosystem because temperatures fall as elevation increases, causing the ecosystem to stratify. This stratification is a crucial ...
and northern coniferous woodlands such as the Sierra Nevada and the Cascade Range in northwestern North America, ''Gyromitra esculenta'' is found widely across the continent, as far south as
Mexico Mexico (Spanish: México), officially the United Mexican States, is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatema ...
. It is also common in Central Europe, less abundant in the east, and more in montane areas than lowlands. It has been recorded from
Northern Ireland Northern Ireland ( ga, Tuaisceart Éireann ; sco, label= Ulster-Scots, Norlin Airlann) is a part of the United Kingdom, situated in the north-east of the island of Ireland, that is variously described as a country, province or region. Nort ...
, from Uşak Province in Western Turkey, and from the vicinity of
Kaş Kaş (; el, Αντίφελλος, translit=Antífellos, translit-std=ISO) is a small fishing, diving, yachting and tourist town, and a district of Antalya Province of Turkey, 168 km west of the city of Antalya. As a tourist resort, it is re ...
in the
Antalya Province Antalya Province ( tr, ) is located on the Mediterranean coast of south-west Turkey, between the Taurus Mountains and the Mediterranean Sea. Antalya Province is the centre of Turkey's tourism industry, attracting 30% of foreign tourists visi ...
of Turkey's southern coast.


Toxicity

Toxic reactions have been known for at least a hundred years. Experts speculated the reaction was more of an allergic one specific to the consumer, or a misidentification, rather than innate toxicity of the fungus, due to the wide range in effects seen. Some would suffer severely or perish while others exhibited no symptoms after eating similar amounts of mushrooms from the same dish. Yet others would be not poisoned after eating ''Gyromitra esculenta'' for many years However, the fungus is now widely recognized as potentially deadly. ''Gyromitra esculenta'' contains levels of the poison gyromitrin that vary locally among populations; although these mushrooms are only rarely involved in poisonings in either
North America North America is a continent in the Northern Hemisphere and almost entirely within the Western Hemisphere. It is bordered to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the southeast by South America and the Car ...
or western
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
, intoxications are seen frequently in eastern Europe and
Scandinavia Scandinavia; Sámi languages: /. ( ) is a subregion in Northern Europe, with strong historical, cultural, and linguistic ties between its constituent peoples. In English usage, ''Scandinavia'' most commonly refers to Denmark, Norway, and Swe ...
. A 1971 Polish study reported at the time that the species accounted for up to 23% of mushroom fatalities each year. Death rates have dropped since the mid-twentieth century; in
Sweden Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
poisoning is common, though life-threatening poisonings have not been detected and there was no fatality reported over the 50 years from 1952 to 2002. ''Gyromitra'' poisonings are rare in Spain, due to the widespread practice of drying the mushrooms before preparation and consumption, but has a mortality rate of about 25%. A lethal dose of gyromitrin has been estimated to be 10–30 mg/kg for children and 20–50 mg/kg in adults. These doses correspond to around and of fresh mushroom respectively. Evidence suggests that children are more severely affected; it is unclear whether this is due to a larger weight consumed per body mass ratio or to differences in enzyme and metabolic activity.


Geographical variation

Populations of ''Gyromitra esculenta'' appear to vary geographically in their toxicity. A French study has shown that mushrooms collected at higher altitudes have lower concentrations of toxin than those from lower elevations, and there is some evidence that fungi west of the
Rocky Mountains The Rocky Mountains, also known as the Rockies, are a major mountain range and the largest mountain system in North America. The Rocky Mountains stretch in straight-line distance from the northernmost part of western Canada, to New Mexico ...
in North America contain less toxin than those to the east. However, poisonings in the west have been reported, although less frequently than in Europe.


Biochemistry

The identity of the toxic constituents eluded researchers until 1968, when acetaldehyde ''N''-methyl-''N''-formylhydrazone, better known as gyromitrin, was isolated. Gyromitrin is a volatile
water-soluble In chemistry, solubility is the ability of a substance, the solute, to form a solution with another substance, the solvent. Insolubility is the opposite property, the inability of the solute to form such a solution. The extent of the solub ...
hydrazine compound hydrolyzed in the body into
monomethylhydrazine Monomethylhydrazine (mono-methyl hydrazine, MMH) is a highly toxic, volatile hydrazine derivative with the chemical formula . It is used as a rocket propellant in bipropellant rocket engines because it is hypergolic with various oxidizers such as ...
(MMH). Other ''N''-methyl-''N''-formylhydrazone derivatives have been isolated in subsequent research, although they are present in smaller amounts. These other compounds would also produce monomethylhydrazine when hydrolyzed, although it remains unclear how much each contributes to the false morel's toxicity. The toxins react with pyridoxal-5-phosphate—the activated form of pyridoxine—and form a hydrazone. This reduces production of the neurotransmitter GABA via decreased activity of
glutamic acid decarboxylase Glutamate decarboxylase or glutamic acid decarboxylase (GAD) is an enzyme that catalyzes the decarboxylation of glutamate to gamma-aminobutyric acid (GABA) and carbon dioxide (). GAD uses pyridoxal-phosphate (PLP) as a cofactor. The reaction p ...
, producing the neurological symptoms. MMH also causes oxidative stress leading to methemoglobinemia. Additionally during the
metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run c ...
of MMH, ''N''-methyl-''N''-formylhydrazine is produced; this then undergoes
cytochrome P450 Cytochromes P450 (CYPs) are a superfamily of enzymes containing heme as a cofactor that functions as monooxygenases. In mammals, these proteins oxidize steroids, fatty acids, and xenobiotics, and are important for the clearance of various co ...
regulated oxidative metabolism which via reactive nitrosamide intermediates leads to formation of methyl radicals which lead to liver necrosis. Inhibition of
diamine oxidase Diamine oxidase (DAO), also known "amine oxidase, copper-containing, 1" (AOC1), formerly called histaminase, is an enzyme () involved in the metabolism, oxidation, and inactivation of histamine and other polyamines such as putrescine or spermid ...
(histaminase) elevates
histamine Histamine is an organic nitrogenous compound involved in local immune responses, as well as regulating physiological functions in the gut and acting as a neurotransmitter for the brain, spinal cord, and uterus. Since histamine was discovered ...
levels resulting in headaches, nausea, vomiting, and abdominal pain.


Symptoms

The symptoms of poisoning are typically
gastrointestinal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
and
neurological Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
. Symptoms occur within 6–12 hours of consumption, although cases of more severe poisoning may present sooner—as little as 2 hours after ingestion. Initial symptoms are gastrointestinal, with sudden onset of
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
, vomiting, and watery
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin w ...
which may be bloodstained.
Dehydration In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
may develop if the vomiting or diarrhea is severe. Dizziness, lethargy,
vertigo Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties w ...
, tremor,
ataxia Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of ...
,
nystagmus Nystagmus is a condition of involuntary (or voluntary, in some cases) eye movement. Infants can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in reduced or limited vision. Due to the invol ...
, and headaches develop soon after;
fever Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single ...
often occurs, a distinctive feature which does not develop after poisoning by other types of mushrooms. In most cases of poisoning, symptoms do not progress from these initial symptoms, and patients recover after 2–6 days of illness. In some cases there may be an
asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ...
phase following the initial symptoms which is then followed by more significant toxicity including
kidney damage Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can b ...
,
liver damage Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Signs and symptoms Some of the si ...
, and neurological dysfunction including seizures and coma. These signs usually develop within 1–3 days in serious cases. The patient develops
jaundice Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme meta ...
and the liver and
spleen The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes .
become enlarged, in some cases
blood sugar Glycaemia, also known as blood sugar level, blood sugar concentration, or blood glucose level is the measure of glucose concentrated in the blood of humans or other animals. Approximately 4 grams of glucose, a simple sugar, is present in the blo ...
levels will rise (
hyperglycemia Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/L (200  mg/dL), but symptoms may not start to become noticeable until even ...
) and then fall (
hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...
) and liver toxicity is seen. Additionally intravascular
hemolysis Hemolysis or haemolysis (), also known by several other names, is the rupturing (lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may occur in vivo o ...
causes destruction of red blood cells resulting in increase in free hemoglobin and
hemoglobinuria Hemoglobinuria is a condition in which the oxygen transport protein hemoglobin is found in abnormally high concentrations in the urine. The condition is caused by excessive intravascular hemolysis, in which large numbers of red blood cells (RBCs) ...
which can lead to
renal The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
toxicity or
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
.
Methemoglobinemia Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood. Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis). Complications m ...
may also occur in some cases. This is where higher than normal levels of
methemoglobin Methemoglobin (British: methaemoglobin) (pronounced "met-hemoglobin") is a hemoglobin ''in the form of metalloprotein'', in which the iron in the heme group is in the Fe3+ (ferric) state, not the Fe2+ (ferrous) of normal hemoglobin. Sometimes, it i ...
, which is a form of
hemoglobin Hemoglobin (haemoglobin BrE) (from the Greek word αἷμα, ''haîma'' 'blood' + Latin ''globus'' 'ball, sphere' + ''-in'') (), abbreviated Hb or Hgb, is the iron-containing oxygen-transport metalloprotein present in red blood cells (erythrocyte ...
that can not carry oxygen, are found in the blood. It causes the patient to become short of breath and
cyanotic Cyanosis is the change of body tissue color to a bluish-purple hue as a result of having decreased amounts of oxygen bound to the hemoglobin in the red blood cells of the capillary bed. Body tissues that show cyanosis are usually in locations ...
. Cases of severe poisoning may progress to a terminal neurological phase, with delirium, muscle
fasciculation A fasciculation, or muscle twitch, is a spontaneous, involuntary muscle contraction and relaxation, involving fine muscle fibers. They are common, with as many as 70% of people experiencing them. They can be benign, or associated with more serio ...
s and seizures, and
mydriasis Mydriasis is the dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs. Normally, as ...
progressing to
coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
, circulatory collapse, and
respiratory arrest Respiratory arrest is a sickness caused by apnea (cessation of breathing) or respiratory dysfunction severe enough it will not sustain the body (such as agonal breathing). Prolonged apnea refers to a patient who has stopped breathing for a long p ...
. Death may occur from five to seven days after consumption.


Treatment

Treatment is mainly supportive; gastric decontamination with
activated charcoal "Activated" is a song by English singer Cher Lloyd. It was released on 22 July 2016 through Vixen Records. The song was made available to stream exclusively on ''Rolling Stone'' a day before to release (on 21 July 2016). Background In an interv ...
may be beneficial if medical attention is sought within a few hours of consumption. However, symptoms often take longer than this to develop, and patients do not usually present for treatment until many hours after ingestion, thus limiting its effectiveness. Patients with severe vomiting or diarrhea can be rehydrated with
intravenous Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...
fluids. Monitoring of biochemical parameters such as methemoglobin levels, electrolytes, liver and kidney function,
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and microscopic examination. Macroscopic e ...
, and
complete blood count A complete blood count (CBC), also known as a full blood count (FBC), is a set of medical laboratory tests that provide cytometry, information about the cells in a person's blood. The CBC indicates the counts of white blood cells, red blood cell ...
is undertaken and any abnormalities are corrected. Dialysis can be used if kidney function is impaired or the kidneys are failing. Hemolysis may require a
blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
to replace the lost red blood cells, while methemoglobinemia is treated with intravenous
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...
. Pyridoxine, also known as
vitamin B6 Vitamin B6 is one of the B vitamins, and thus an essential nutrient. The term refers to a group of six chemically similar compounds, i.e., "vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosphat ...
, can be used to counteract the
inhibition Inhibitor or inhibition may refer to: In biology * Enzyme inhibitor, a substance that binds to an enzyme and decreases the enzyme's activity * Reuptake inhibitor, a substance that increases neurotransmission by blocking the reuptake of a neurotra ...
by MMH on the pyridoxine-dependent step in the synthesis of the
neurotransmitter A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell. Neuro ...
GABA. Thus GABA synthesis can continue and symptoms are relieved. Pyridoxine, which is only useful for the neurological symptoms and does not decrease hepatic toxicity, is given at a dose of 25 mg/kg; this can be repeated up to a maximum total of 15 to 30 g daily if symptoms do not improve.
Benzodiazepine Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
s are given to control seizures; as they also modulate GABA receptors they may potentially increase the effect of pyridoxine. Additionally MMH inhibits the chemical transformation of
folic acid Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and ...
into its active form,
folinic acid Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. It is also used in combination with 5-fluorouracil to treat colorectal cancer and pancreatic cancer, may be used to tr ...
, this can be treated by folinic acid given at 20–200 mg daily.


Carcinogenicity

Monomethylhydrazine, as well as its precursors methylformylhydrazine and gyromitrin and raw ''Gyromitra esculenta'', have been shown to be
carcinogen A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis (the formation of cancer). This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substan ...
ic in experimental animals. Although ''Gyromitra esculenta'' has not been observed to cause cancer in humans, it is possible there is a carcinogenic risk for people who ingest these types of mushrooms. Even small amounts may have a carcinogenic effect. At least 11 different hydrazines have been isolated from ''Gyromitra esculenta'', and it is not known if the potential carcinogens can be completely removed by parboiling.


Consumption

Despite its recognized toxicity, ''Gyromitra esculenta'' is marketed and consumed in several countries or states in Europe and North America. It was previously consumed in Germany, with fungi picked in and exported from
Poland Poland, officially the Republic of Poland, is a country in Central Europe. It is divided into 16 administrative provinces called voivodeships, covering an area of . Poland has a population of over 38 million and is the fifth-most populous ...
; more recently, however, Germany and
Switzerland ). Swiss law does not designate a ''capital'' as such, but the federal parliament and government are installed in Bern, while other federal institutions, such as the federal courts, are in other cities (Bellinzona, Lausanne, Luzern, Neuchâtel ...
discouraged consumption by prohibiting its sale. Similarly in
Sweden Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
, the
Swedish National Food Administration The Swedish National Food Agency ( sv, Livsmedelsverket) is a Swedish government agency that answers to the Ministry of Agriculture, Food and Consumer Affairs. The agency is located in Uppsala. It is the central supervisory authority for matters r ...
warns that it is not fit for human consumption, and restricts purchase of fresh mushrooms to restaurants alone. The mushroom is still highly regarded and consumed in
Bulgaria Bulgaria (; bg, България, Bǎlgariya), officially the Republic of Bulgaria,, ) is a country in Southeast Europe. It is situated on the eastern flank of the Balkans, and is bordered by Romania to the north, Serbia and North Macedon ...
, being sold in markets and picked for export there. In some countries such as Spain, especially in the eastern
Pyrenees The Pyrenees (; es, Pirineos ; french: Pyrénées ; ca, Pirineu ; eu, Pirinioak ; oc, Pirenèus ; an, Pirineus) is a mountain range straddling the border of France and Spain. It extends nearly from its union with the Cantabrian Mountains to C ...
, they are traditionally considered a delicacy, and many people report consuming them for many years with no ill effects. Despite this, the false morel is listed as hazardous in official mushroom lists published by the Catalan Government and sale to the public is prohibited throughout Spain. Outside of Europe, ''Gyromitra esculenta'' is consumed in the
Great Lakes The Great Lakes, also called the Great Lakes of North America, are a series of large interconnected freshwater lakes in the mid-east region of North America that connect to the Atlantic Ocean via the Saint Lawrence River. There are five lakes ...
region and some western states in the United States. Selling and purchasing fresh false morels is legal in Finland, where it is highly regarded. However, the mushrooms are required by law to be accompanied with a warning that they are poisonous and legally prescribed preparation instructions. False morels are also sold prepared and canned, in which case they are ready to be used. Official figures from the Finnish Ministry of Agriculture and Forestry report a total amount of false morels sold in Finland of 21.9 
tonne The tonne ( or ; symbol: t) is a unit of mass equal to 1000  kilograms. It is a non-SI unit accepted for use with SI. It is also referred to as a metric ton to distinguish it from the non-metric units of the short ton ( United State ...
s in 2006 and 32.7 tonnes, noted as being above average, in 2007. In 2002, the Finnish Food Safety Authority estimated annual consumption of false morels to be hundreds of tonnes in plentiful years. In
Finnish cuisine Finnish cuisine is notable for generally combining traditional country fare and ''haute cuisine'' with contemporary continental style cooking. Fish and meat (usually pork, beef or reindeer) play a prominent role in traditional Finnish dishes in ...
, false morels may be cooked in an
omelette In cuisine, an omelette (also spelled omelet) is a dish made from beaten eggs, fried with butter or oil in a frying pan (without stirring as in scrambled egg). It is quite common for the omelette to be folded around fillings such as chives, ve ...
, or gently sautéed in butter in a saucepan, flour and milk added to make a
béchamel sauce Bechamel sauce ( ) is a sauce traditionally made from a white roux (butter and flour in a 1:1 mixture by weight) and milk. Bechamel may also be referred to as besciamella (Italy), besamel (Greece), or white sauce (U.S.). French, Italian and Greek ...
, or pie filling. Alternatively, more fluid can be added for a false morel soup. Typical condiments added for flavour include
parsley Parsley, or garden parsley (''Petroselinum crispum'') is a species of flowering plant in the family Apiaceae that is native to the central and eastern Mediterranean region (Sardinia, Lebanon, Israel, Cyprus, Turkey, southern Italy, Greece, Por ...
,
chives Chives, scientific name ''Allium schoenoprasum'', is a species of flowering plant in the family Amaryllidaceae that produces edible leaves and flowers. Their close relatives include the common onions, garlic, shallot, leek, scallion, and ...
,
dill Dill (''Anethum graveolens'') is an annual herb in the celery family Apiaceae. It is the only species in the genus ''Anethum''. Dill is grown widely in Eurasia, where its leaves and seeds are used as a herb or spice for flavouring food. Growth ...
and
black pepper Black pepper (''Piper nigrum'') is a flowering vine in the family Piperaceae, cultivated for its fruit, known as a peppercorn, which is usually dried and used as a spice and seasoning. The fruit is a drupe (stonefruit) which is about in diame ...
. While cooking the fungus expels the toxins, the cook can inhale them through steam.


Controversies

In 2015, Swedish chef caused a controversy when he prepared a dish with ''Gyromitra esculenta'' in a TV show. Mushroom expert Monica Svensson criticized him for including it, because of the mushroom's carcinogenic substances and the risk that inexperienced people might misinterpret the recipe and omit the steps that reduce the toxicity level. She also expressed criticism to
Per Morberg Per-Arne Henrik Morberg (; born 23 June 1960) is a Swedish actor, chef, and TV host. Biography Morberg grew up in Hökarängen and Sköndal in Stockholm. He competed in judo when he was a teenager. He is a black belt and was named Swedish a ...
for similar reasons. Paul Svensson said that he was not aware of the carcinogenic effects and apologized afterwards, and he promised to remove the mushroom from his dishes.


Preparation

Most of the gyromitrin must be removed to render false morels edible. The recommended procedure involves either first drying and then boiling the mushrooms, or boiling the fresh mushrooms directly. To prepare fresh mushroom it is recommended that they are cut into small pieces and
parboiled Parboiling (or leaching) is the partial or semi boiling of food as the first step in cooking. The word is from the Old French 'parboillir' (to boil thoroughly) but by mistaken association with 'part' it has acquired its current meaning. The wo ...
twice in copious amounts of water, at least three parts water to one part chopped mushrooms, for at least five minutes, after each boiling the mushroom should be rinsed thoroughly in clean water. Each round of parboiling reduces the gyromitrin contents to a tenth. The gyromitrin is leached into the water where it will remain, therefore the parboiling water must be discarded and replaced with fresh water after each
round Round or rounds may refer to: Mathematics and science * The contour of a closed curve or surface with no sharp corners, such as an ellipse, circle, rounded rectangle, cant, or sphere * Rounding, the shortening of a number to reduce the number ...
of boiling. However, it is still recommended that the mushroom be boiled after drying. MMH boils at and thus readily vaporizes into the air when water containing fresh false morels is boiled. Poorly ventilated spaces allow vapor to accumulate, resulting in gyromitrin poisoning. If boiling the mushrooms indoors, care should be taken to ensure adequate ventilation, and, if symptoms of gyromitrin poisoning appear, immediately seek fresh air. Even after boiling, small amounts of gyromitrin remain in the mushrooms. Given the possibility of accumulation of toxins, repeated consumption is not recommended.


Prospects for cultivation

Strains with much lower concentrations of gyromitrin have been discovered, and the fungus has been successfully grown to fruiting in culture. Thus there is scope for future research into cultivation of safer strains.


See also

*
List of deadly fungi Although many people have a fear of mushroom poisoning by "toadstool A mushroom or toadstool is the fleshy, spore-bearing fruiting body of a fungus, typically produced above ground, on soil, or on its food source. ''Toadstool'' generally denot ...


References

; General * ; Specific


External links


"''Gyromitra esculenta'', one of the false morels"




{{featured article Discinaceae Deadly fungi Finnish cuisine Fungi of North America Fungi of Europe Edible fungi Fungi described in 1800 Taxa named by Christiaan Hendrik Persoon Potentially dangerous food