{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:46:04Z","timestamp":1777934764210,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>A middle-aged male was admitted to the clinic 4 d after ingestion of wild mushrooms. His medical history included type 2 diabetes, hypertension, and coronary bypass. Initially misdiagnosed with infectious enterocolitis, the patient was treated as an outpatient with intravenous fluids while continuing his chronic medications (i.e., statins, beta-blockers, and aspirin). On Day 3, blood tests confirmed hepatorenal syndrome, and the patient was transferred to the clinic. On admission, he was alert with a blood pressure of 100\/60\u2005mmHg, heart rate of 100 beats\/min, sinus rhythm, right upper quadrant pain, and jaundice. Lab results showed thrombocytopenia, severe hepatorenal dysfunction, prolonged prothrombin time (29.3\u2005s), and a Model for End-Stage Liver Disease score of 30. For 3 d, the patient was simultaneously exposed to amatoxin and chronic cardiovascular medications, both substrates for the same transporters. Treatment was adjusted to intravenous acetylcysteine (double regimen), oral silymarin (600\u2005mg\/d), and supportive therapy. The patient recovered within 10 d, with transaminases normalizing after 3 mo. Understanding transporter-related drug interactions and patient-specific metabolic differences may improve future management strategies and patient survival. Further research is needed on alternative inhibitors of amatoxin uptake and competitive organic anion-transporting polypeptide substrates to expand treatment options.<\/jats:p>","DOI":"10.1177\/10806032251338278","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T20:07:11Z","timestamp":1747253231000},"page":"389-396","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Treatment of Misdiagnosed Mushroom Poisoning: Do Organic Anion Transporting Polypeptide Substrates Matter?"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5922-6336","authenticated-orcid":false,"given":"Zanina","family":"Pereska","sequence":"first","affiliation":[{"name":"Medical Faculty, University Clinic of Toxicology, Ss. 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