Main features of Cortinarius spp. poisoning: a literature review

Introduction: Cortinarius spp. poisoning is characterized by a delayed acut e renal failure. The main features of this severe poisoning are still poorl y known and often overlooked. The aim of this literature review is a better description of Cortinarius spp. poisoning. Materials and Methods: The main medical databases were searched: Abstracts of Mycology, Current Contents, Medline, Pascal, Micromedex Poisindex, Toxic ology abstracts, Toxline. All case reports that included a description of t he clinical features of Cortinarius spp. poisoning were studied. Results: 245 cases were collected and 90 cases could be analyzed in details . Gastrointestinal disorders are the main symptoms of the prerenal phase of the poisoning. They appear a few days after the ingestion of the mushrooms (median 3 days). The renal phase is delayed (median 8.5 days). Moderate an d transient hepatic abnormalities have been reported. A severe hepatic fail ure can be ruled out. Muscular lesions are highly questionable. Treatment i s supportive. No specific treatment can be recommended. Acute renal failure progressed towards chronic renal failure in half of the cases; intermitten t hemodialysis or kidney transplantations were necessary in 70% of those ca ses. Conclusion: Cortinarius spp. poisoning is severe. Ingestion of Cortinarius species must be systematically suspected whenever tubulo-interstitial nephr itis is diagnosed, especially as mushrooms may have been ingested 1-2 weeks before. (C) 2001 Elsevier Science Ltd. All rights reserved.