Objectives: To study the frequency, severity, and long-term outcome of renal injury in Cortinarius orellanus poisoning, to evaluate the association between the ingested amount of C. orellanus and outcome, and to evaluate the effect of N-acetylcysteine and corticosteroid treatment on outcome. Methods: Case series of eight patients. Diagnosis and severity of acute kidney injury (AKI) and chronic kidney disease (CKD) were classified according to current AKI and CKD definitions. N-acetylcysteine and corticosteroids were administered to six patients, former according to the standard for paracetamol poisoning. Main findings: All patients developed AKI, six in the most severe stage and four required renal replacement therapy (RRT). After 12 months, seven patients presented with CKD, of whom three required chronic RRT and further two were in advanced CKD. AKI and CKD severity highly correlated with the consumed amounts of Cortinarius orellanus (r ¼ 0.98, p50.001 and r ¼ 0.78, p ¼ 0.02, respectively) but not with N-acetylcysteine and corticosteroid treatment. Conclusions: AKI and CKD by current definitions and classifications are frequent and severe after Cortinarius orellanus poisoning. The ingested amount of Cortinarius orellanus correlates with the severity of both AKI and CKD. N-acetylcysteine and corticosteroid treatment do not seem to have a beneficial effect on either AKI or CKD.

I read the article on investigating hematuria with great interest (1). Unfortunately, one cause was not mentioned, although it occurs at a rate that is relevant: deeply infiltrating endometriosis of bladder or ureter.Reliable data on rates hardly exist, but according to estimates, 1-2% of patients with endometriosis have urogenital endometriosis. The symptoms depend on a woman's monthly cycle, but in advanced findings they can occur independently of the monthly cycle. For this reason, this cause should always be considered in premenopausal women with hematuria, and patients should be referred for a gynecological examination.

Die Arbeit gibt einen Überblick über neuere Pilzvergiftungen, ihre Symptome und Toxine, soweit bekannt. Vergiftungen sind meist Folge von Verwechslungen mit Speise‐ oder “Heilpilzen”. Giftige Arten, wie der Große Stachelschirmling, Ohrförmige Weißseitling, Parfümierte Trichterling und der Ölbaumtrichterling kommen in Mitteleuropa vor. Wenig bekannt ist, dass reichlicher Morchelgenuss zu neurologischen Symptomen führen kann. Aus Asien sind Arten bekannt geworden, die schwerste Intoxikationen hervorrufen. Das “Yunnan Sudden Unexplained Death”‐Syndrom konnte mit dem Verzehr des “little white mushroom” (Trogia venenata) erklärt werden. Die oft tödlich verlaufenden Rhabdomyolysen nach Verzehr von Russula subnigricans beruhen auf Cycloprop‐2ene‐Karbonsäure. Besonders folgenschwer sind Verwechslungen vom als “Pilz der Unsterblichkeit” geschätzten “Reishi” mit Ganoderma neo‐japonicum oder Podostroma cornu‐damae, dem weltweit giftigsten Pilz.

No abstract