The authors present the case reports of a 30-year-old man and his 29-year-old wife who ingested a mushroom meal containing Cortinarius speciosissimus. Features of this intoxication include gastrointestinal symptoms such as nausea, vomiting, and diarrhea as well as back pain. The toxin orellanine is nephrotoxic and can lead to acute renal failure. A long symptom-free interval of 2 to 21 days is characteristic of this poisoning. The diagnosis can be made by mycologic testing or by toxicologic analysis of a renal biopsy specimen. Reported therapeutic options include hemodialysis, plasmapheresis, or drug therapy with corticosteroids, all of which have yielded variable results. Here the authors report the use of antioxidant therapy in 2 patients with acute renal failure caused by Cortinarius speciosissimus intoxication.

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http://dx.doi.org/10.1053/j.ajkd.2003.12.037DOI Listing

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