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High-dose antioxidant therapy and steroids might improve the outcome of acute renal failure from intoxication by Cortinarius rubellus: report of two cases.

Kerschbaum J, Mayer G, Maurer A - Clin Kidney J (2012)

Bottom Line: 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.Dialysis was never necessary in both patients and renal function was almost normal at the end of follow-up.Early treatment with high-dose antioxidant therapy and steroids might be effective in reducing the risk of chronic renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine IV (Nephrology and Hypertension) , Medical University Innsbruck , Innsbruck , Austria.

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.

No MeSH data available.


Related in: MedlinePlus

Cortinarius rubellus.
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SFS129F2: Cortinarius rubellus.

Mentions: Both patients were started on prednisolone 1 mg/kg once daily and treated with intravenous N-acetylcysteine in the dosage used for intoxication with paracetamol (150 mg/kg over 15 min, followed by 50 mg/kg over 4 h and 100 mg/kg over 16 h). Renal function of both patients improved significantly over the course of the next 8 days and they were discharged from the hospital on a reducing course of prednisolone. After that, a meeting between the two patients and the biologist who had carried out the toxin analysis of the renal biopsy specimen was undertaken, which revealed that with the utmost probability the causative mushroom was C. rubellus (Figure 2) which is rather common in this part of Tyrol.Fig. 2.


High-dose antioxidant therapy and steroids might improve the outcome of acute renal failure from intoxication by Cortinarius rubellus: report of two cases.

Kerschbaum J, Mayer G, Maurer A - Clin Kidney J (2012)

Cortinarius rubellus.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400554&req=5

SFS129F2: Cortinarius rubellus.
Mentions: Both patients were started on prednisolone 1 mg/kg once daily and treated with intravenous N-acetylcysteine in the dosage used for intoxication with paracetamol (150 mg/kg over 15 min, followed by 50 mg/kg over 4 h and 100 mg/kg over 16 h). Renal function of both patients improved significantly over the course of the next 8 days and they were discharged from the hospital on a reducing course of prednisolone. After that, a meeting between the two patients and the biologist who had carried out the toxin analysis of the renal biopsy specimen was undertaken, which revealed that with the utmost probability the causative mushroom was C. rubellus (Figure 2) which is rather common in this part of Tyrol.Fig. 2.

Bottom Line: 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.Dialysis was never necessary in both patients and renal function was almost normal at the end of follow-up.Early treatment with high-dose antioxidant therapy and steroids might be effective in reducing the risk of chronic renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine IV (Nephrology and Hypertension) , Medical University Innsbruck , Innsbruck , Austria.

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.

No MeSH data available.


Related in: MedlinePlus