title: [Voluntary poisoning by Cortinarius orellanus: usefulness of an original early treatment after determination of orellanine in the biological fluids and tissues].
abstract: Cortinarius poisoning is generally caused by orellanine, a hydroxy bipyridine N, N-dioxide. This intoxication is characterized by acute nephritis which can lead to death without treatment. We reported a highly sensitive and simple fluorimetric technique to analyse orellanine by thin-layer chromatography on the basis of its characteristic photodecomposition into orelline. Using this procedure, we detected and assayed orellanine for the first time in plasma and renal biopsies of a woman who had deliberately ingested two fruit-bodies of Cortinarius orellanus. An early original treatment was carried out based on hemodialysis, combination plasmapheresis-hemoperfusion, and amino acids and diltiazem administration. These results indicate that it is now possible to make a precise diagnosis of orellanine poisoning.
authors.affiliation: Laboratoire de Biochimie-Immunochimie, Centre Hospitalier Général, Perpignan.
authors.forename: N
authors.initials: N
authors.lastname: Delpech
authors.forename: S
authors.initials: S
authors.lastname: Rapior
authors.forename: P
authors.initials: P
authors.lastname: Donnadieu
authors.forename: A P
authors.initials: AP
authors.lastname: Cozette
authors.forename: J P
authors.initials: JP
authors.lastname: Ortiz
authors.forename: G
authors.initials: G
authors.lastname: Huchard
mesh_terms: D015082:2,2'-Dipyridyl / Q000031:analogs & derivatives* / Q000032:analysis / Q000528:radiation effects; D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000363:Agaricales; D000596:Amino Acids / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use; D001706:Biopsy; D002855:Chromatography, Thin Layer; D003131:Combined Modality Therapy; D004110:Diltiazem / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D005470:Fluorometry; D005665:Furosemide / Q000627:therapeutic use; D006464:Hemoperfusion; D006801:Humans; D007668:Kidney / Q000737:chemistry / Q000473:pathology; D009145:Mushroom Poisoning / Q000097:blood / Q000150:complications* / Q000628:therapy; D009183:Mycotoxins / Q000032:analysis* / Q000528:radiation effects; D010777:Photochemistry; D010956:Plasmapheresis; D006435:Renal Dialysis
chemical_list: D000596:Amino Acids; D009183:Mycotoxins; C030076:orellanine; D015082:2,2'-Dipyridyl; D005665:Furosemide; D004110:Diltiazem; D001205:Ascorbic Acid; D004298:Dopamine
vernacular_title: Intoxication volontaire par Cortinarius orellanus: intérêt d'un traitement précoce original après dosage de l'orellanine dans les milieux biologiques et tissulaires.