Two cases of acute renal failure complicated by the poisoning of amanita virosa / 대한내과학회지

ABSTRACT

Although the most of mushroom poisoning have a clinical menifestation of mild to moderate gastroenteritis, some mushroom may cause a serious illness; acute renal failure, hepatic necrosis. We experienced two cases of acute renal failure complicated by the poisoning of amanita virosa. Amanita virosa have a amatoxin. Amatoxin deteriorate hepatocytes, renal tubular cells, intestinal mucosal cells, and pancreas. They were transferred from local hospital for renal failure management. On admission, blood urea nitrogen and serum creatinine were highly elevated. We diagnosed acute renal failure complicated by poisoning of amanita virosa. In one case, renal function was further deteriorated compared with initial laboratory findings after creatinine was normalized at fifth day. Thus, we did a kidney biopsy. Light microscopy and EM showed interstitial inflammation and moderate tubular atrophy. They were recovered with the supportive management. We report two cases of mushroom poisoning-induced acute renal failure with review of literature.