Plasma exchange in acute renal failure by cortinarius speciosissimus
Busnach, G.; Dal Col, A.; Perrino, M.L.; Surian, M.; Rovati, C.; Barbiano di Belgioioso, G.; Minetti, L.
International Journal of Artificial Organs 6(Suppl 1): 73-74
1983
ISSN/ISBN: 0391-3988 PMID: 6642741 Document Number: 3279
Mushroom poisoning by Cortinarius speciosissimus (C. spec.) leading to irreversible renal failure has been described; in a recent report, an expected bad prognosis has probably been overcome as a result of the very early use of hemoperfusion. In Sep. '81, a healthy couple of wife and husband, both aged 38, had gastrointestinal symptoms 2 days after ingestion of C. spec. On day 8 an acute renal failure developed and the same day, before dialysis, plasma exchange (PE) was undertaken. Renal biopsies disclosed a common pattern of tubular necrosis, scattered infiltrates and interstitial edema. Diuresis and partial recovery started in the man on day 10, while failure persisted over six months in the woman. Further to individual sensitivity to C. spec. toxins, renal damage, once established, may be irreversible, irrespectively of early treatment. Limited usefulness of PE in C. spec. poisoning is probably related to the long latency between ingestion and occurrence of the first renal symptoms.
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