title: Renal involvement in mushroom poisoning: The case of Orellanus syndrome.
abstract: Although mushroom poisoning is a rare cause of acute renal injury, in some cases it may lead to the development of a severe and irreversible renal failure. Orellanus syndrome is the most important example of organic renal damage related to mushroom consumption. It is caused by the ingestion of orellanine, the main toxin of different types of Cortinarius mushrooms (Cortinarius speciosissimus, C. orellanus, C. orellanoides, etc.), and it is characterized by progressive clinical phases with a predominant kidney involvement, finally requiring renal replacement therapy in about 10% of cases. Renal damage is often late and associated with a histological picture of interstitial nephritis. Diagnosis is essentially clinical and no specific therapy has been shown to be effective in preventing and treating renal damage. Here, we describe the case of a patient with mixed wild mushroom poisoning, presenting the typical clinical signs and course of the Orellanus syndrome. This case offers us the opportunity to review the main clinical features of this severe and little-known intoxication.
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Pasquale
authors: P
authors: Esposito
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Edoardo
authors: E
authors: La Porta
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Marta
authors: M
authors: Calatroni
authors: First Department of Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Stefania
authors: S
authors: Bianzina
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Carmelo
authors: C
authors: Libetta
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Marilena
authors: M
authors: Gregorini
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Teresa
authors: T
authors: Rampino
authors: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors: Antonio
authors: A
authors: Dal Canton
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D009145:Mushroom Poisoning / Q000150:complications*; D006435:Renal Dialysis / Q000379:methods*; D013577:Syndrome
keywords: Cortinarius; Mushroom poisoning; acute kidney injury; hemodialysis; orellanine