Serious mushroom poisoning by Cortinarius and Amanita virosa
Svendsen, B.Spillum.; Gjellestad, A.; Eivindson, G.; Berentsen, G.; Jacobsen, D.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 122(8): 777-780
2002
ISSN/ISBN: 0029-2001 PMID: 12092067 Document Number: 543003
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. We discuss the toxicity, clinical features and treatment of the orellanus and the phalloides syndromes and present six case histories. 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.