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[Acute renal failure as a sequela of mushroom poisoning with Cortinarius speciocissimus].

BACKGROUND
Poisoning with the mushroom Cortinarius speciocissimus is a rare event. Within 2-17 days after ingestion unspecific symptoms appear. Characteristically, this state is soon followed by irreversible kidney damage which finally requires chronic hemodialysis.


CASE REPORT
A 46-year-old man was admitted with nausea, vomiting and acute anuria 9 days after he had eaten Cortinarius speciocissimus. Hemodialysis had to be started. Kidney biopsy revealed an interstitial nephritis. This finding corresponds to earlier case reports about intoxication with orellanine, the poison of Cortinarius speciocissimus. 6 months later the kidney function had not recovered leaving the patient to chronic hemodialysis.


CONCLUSION
The prognosis of poisoning with that mushroom is poor. The amount of ingested poison is crucial. Monitoring of kidney function is mandatory when poisoning is suspected. Therapy is directed to symptoms. Usually dialysis has to be commenced. To rule out other causes for kidney damage, a kidney biopsy is required.