Eosinophilia and gastrointestinal symptoms after ingestion of shiitake mushrooms☆,☆☆,★,★★,♢
Section snippets
Challenge of index subject
During the cholesterol-lowering study, one subject, a 56-year-old man, had severe abdominal cramping prompting an emergency room evaluation that was remarkable for an eosinophilia of 9700/mm3. The challenge study in this index subject was conducted after his symptoms had resolved and his eosinophil counts had normalized. He ingested the same daily dose as that used in the cholesterol-lowering study, but with shiitake mushrooms from a different source. Imported dried shiitake mushrooms were
Challenge of index subject
While ingesting 4 gm shiitake powder daily for 14 days, the subject experienced mild abdominal discomfort (not severe discomfort as previously experienced in the cholesterol-lowering study), eosinophilia, and an elevated serum MBP level (Table I). By day 12, cytokines that enhance eosinophil viability were detected in the subject's serum (Table I). Four days after the last ingestion of shiitake powder, his symptoms had resolved. Seventeen days after the last shiitake ingestion,
Discussion
This is the first report of eosinophilia and gastrointestinal changes after shiitake mushroom ingestion. Other immunologic reactions associated with the shiitake mushroom have been described. These reactions have included contact dermatitis, generalized pruritus, and hypersensitivity pneumonitis.19, 20, 21 However, eosinophilia has not been associated with these findings, and in our study no participant experienced skin or lung symptoms.
Here we have demonstrated that a chance observation of
Acknowledgements
We thank Ms. Debbie Jacobson of the University of Colorado for the cholesterol-lowering study information, Mr. Richard Jones for the IgE antibody determinations, Mr. Mark Swanson for the IgG antibody determinations, Dr. Allan Zinsmeister for statistical advice, Ms. Diane Squillace for the MBP assays, Ms. Kathleen Bartemes for the EDN and eosinophil viability determinations, Ms. Sandra Dunnette and Mr. Louis Kost for preparation of graphic materials, Ms. Cheryl Adolphson for editorial
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Cited by (0)
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From athe Division of Gastroenterology and Hepatology and Internal Medicine and bthe Department of Immunology, Mayo Clinic and Mayo Foundation, Rochester; and cthe Fitzsimmons Army Medical Center, Denver.
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Supported in part by grants from the National Institutes of Health (AI 15231, AI 09728, AI 34577, AI 34486, DK 07198, and DK 32121), the Mayo Foundation, and United States Army research funds.
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as a reflection of the views of the Department of the Army or the Department of Defense.
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Reprint requests: Gerald J. Gleich, MD, Department of Immunology, Mayo Clinic, Rochester, MN 55905.
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