title: High-dose antioxidant therapy and steroids might improve the outcome of acute renal failure from intoxication by Cortinarius rubellus: report of two cases.
abstract: Only a small number of cases with favourable outcome after acute renal failure due to intoxication by Cortinarius sp. have been reported in the literature, and approximately half of the patients develop chronic renal failure and dialysis-dependency. We report the case of a couple with acute renal failure after accidental intake of Cortinarius rubellus and a favourable outcome after treatment with high-dose antioxidant therapy with N-acetylcysteine and steroids. Dialysis was never necessary in both patients and renal function was almost normal at the end of follow-up. Underdiagnosis of this rare cause of acute renal failure is likely due to the fact that affected patients develop symptoms of intoxication after a delay of 2-30 days. In patients with unclear acute renal failure with or without gastrointestinal symptoms, intoxication from Cortinarius sp. should be considered as a differential diagnosis. Early treatment with high-dose antioxidant therapy and steroids might be effective in reducing the risk of chronic renal failure.
authors.affiliation: Department of Internal Medicine IV (Nephrology and Hypertension) , Medical University Innsbruck , Innsbruck , Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Kerschbaum
authors.affiliation: Department of Internal Medicine IV (Nephrology and Hypertension) , Medical University Innsbruck , Innsbruck , Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Mayer
authors.affiliation: Department of Internal Medicine IV (Nephrology and Hypertension) , Medical University Innsbruck , Innsbruck , Austria.
authors.forename: Anton
authors.initials: A
authors.lastname: Maurer
keywords: Cortinarius rubellus; acute renal failure; intoxication; therapy