title: [Serious mushroom poisoning by Cortinarius and Amanita virosa].
abstract: BACKGROUND
  Following a characteristic long latent period (3-17 days), the nephrotoxins of Cortinarius rubellus and Cortinarius orellanus can cause the orellanus syndrome, due to severe damage of the proximal tubular epithelium. Amanita virosa is known to produce serious toxic effects in the liver and the kidneys after an initial asymptomatic latent phase.
  
  
  METHODS
  We discuss the toxicity, clinical features and treatment of the orellanus and the phalloides syndromes and present six case histories.
  
  
  CONCLUSIONS
  Ingestion of Cortinarius rubellus and Cortinarius orellanus resulted in permanent renal failure in four out of five patients, following a latent period of about ten days. One patient who ingested Amanita virosa, developed hepatotoxicity. He was given silibinin and symptomatic treatment and recovered. After ingestion of Cortinarius rubellus and Cortinarius orellanus, no specific treatment is available. The therapy is directed toward the renal failure, including dialysis and possible transplantation. Poisoning by Amanita virosa is treated with the nonspecific antidote silibinin.
authors.affiliation: Giftinformasjonssentralen Postboks 8189 Dep 0034 Oslo. b.j.s.svendsen@giftinfo.no
authors.forename: Barbro Spillum
authors.initials: BS
authors.lastname: Svendsen
authors.forename: Axel
authors.initials: A
authors.lastname: Gjellestad
authors.forename: Gunvald
authors.initials: G
authors.lastname: Eivindson
authors.forename: Gerd
authors.initials: G
authors.lastname: Berentsen
authors.forename: Dag
authors.initials: D
authors.lastname: Jacobsen
mesh_terms: D000328:Adult; D000363:Agaricales / Q000737:chemistry; D000368:Aged; D000545:Amanita / Q000737:chemistry; D000931:Antidotes / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D009183:Mycotoxins / Q000737:chemistry / Q000506:poisoning; D006435:Renal Dialysis; D012838:Silymarin / Q000627:therapeutic use
chemical_list: D000931:Antidotes; D009183:Mycotoxins; D012838:Silymarin