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SUMMARY.Free carnitine, acylcarnitine and total carnitine serum concentrations have been measured in chronic renal insufficiency patients under conservative treatment, in patients under regular haemodialysis treatment and in healthy controls. In the undialysed patients the levels of free camitine, acylcamitine and total carnitine were all clearly higher than those of the control group. The free carnitine and total carnitine levels of undialysed subjects were also higher than in regularly haemodialysed patients, showing that dialysis produces plasma carnitine losses that are not compensated for by endogenous synthesis of camitine (this finding supports published reports of tissue camitine deficiency in patients undergoing regular haemodialysis). The acylcarnitine levels of dialysed and undialysed patients were not significantly different, however; both were very much higher than that of control group. The hypercarnitinaemia of the patients under conservative treatment suggests that the impairment of renal function causes a reduction in the elimination of camitine via the kidney.

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‘Magic mushrooms’ ingestion among the drug-using population has become a popular cheap way to get hallucinogenic effects which is not free of complications. One of these is acute renal failure related to Cortinarius genus intake. This one greatly resembles ‘magic mushrooms’ and confusion is possible for inexperienced collectors. We report the case of a young male ex-drug addict who developed acute tubulointerstitial nephritis after voluntary ingestion of Cortinarius orellanus. The clinical picture was preceded by a long latency period, had an insidious course without any data of hepatoxicity and evolved to a chronic state. Renal biopsy showed nonspecific histopathological findings. In summary, it is important to bear this possibility in mind when facing an acute tubulointerstitial nephritis of unknown origin in a drug-taking patient.

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