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End-stage renal failure from mushroom poisoning with Cortinarius orellanus: report of four cases and review of the literature.

Abstract
Mushrooms of the ubiquitous Cortinarius species (Cs) contain nephrotoxins that can cause acute and chronic renal failure by an unknown pathomechanism. Typical is a long symptom-free interval before the onset of clinical disease. A causal form of therapy is not known. Early hemodialysis can improve the prognosis of this potentially life-threatening condition. Diagnosis of Cs poisoning can be made by detecting the responsible toxin--orellanine--in plasma or renal tissue by fluorimetry after thin-layer chromatography or by identifying the spores of left-over mushrooms as Cs. Renal histology shows nonspecific changes such as tubular dilatation and flattening of the epithelium and signs of interstitial edema followed by interstitial fibrosis. We present four cases of Cs poisoning with different outcomes and a review of the literature.
AuthorsS Horn, J H Horina, G J Krejs, H Holzer, M Ratschek
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 30 Issue 2 Pg. 282-6 (Aug 1997) ISSN: 0272-6386 [Print] United States
PMID9261043 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Mycotoxins
  • orellanine
  • 2,2'-Dipyridyl
Topics
  • 2,2'-Dipyridyl (analogs & derivatives, analysis)
  • Adult
  • Aged
  • Female
  • Humans
  • Kidney (pathology)
  • Kidney Failure, Chronic (etiology, pathology)
  • Male
  • Middle Aged
  • Mushroom Poisoning (complications, diagnosis)
  • Mycotoxins (analysis)

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