Amanita poisonings resulting in acute, reversible renal failure: new cases, new toxic Amanita mushrooms

Abstract

A. boudieri, A. gracilior and A. echinocephala are nephrotoxic. These intoxications are clinically similar to that of A. smithiana, with acute reversible renal failure and mild hepatitis but are different in their clinical picture from Orellanus syndrome characterized by a delayed onset of severe and often irreversible renal failure.

Mycetism: A Review of the Recent Literature

“…For instance, genus Amanita contains seven sections: two sections contain nontoxic mushrooms and the remaining sections contain some poisonous species. Within this genus, the various poisonous species contain different toxins and produce different clinical syndromes [3,4] (see Fig. 1).…”

“…Mushrooms in the Phalloideae section produce fulminant hepatic failure, while mushrooms in the Lepidella and Amidella sections produce primarily acute renal injury and mushrooms in the Amanita class produce an inebriating syndrome. Sources: Mendez-Navarro et al [3] and Kirchmair et al [4] and Kirchmair and Poder [5] treatment with an antidote seems prudent [26] (see Table 3 and hepatotoxic mushroom section below).…”

“…This presentation is sometimes referred to as the "Orellanus syndrome" [4]. Patients present with delayed vomiting and diarrhea followed by oliguria or anuria [129][130][131][132].…”

“…Relatively accelerated nephrotoxic mushroom syndromes are described after Amanita proxima (Mediterranean Amidella) and Amanita smithiana (toxic Lepidella Amanita or North American Lepidella) ingestions [4]. This is sometimes referred to as the "Amanita nephrotoxic syndrome" [4].…”

“…This is sometimes referred to as the "Amanita nephrotoxic syndrome" [4]. A. smithiana has been found along the Pacific coast of North America and less commonly in Idaho, Nevada and New Mexico [135].…”