Acute Renal Failure as a Result of Mushroom Poisoning

Abstract

Dear Editor, Mushroompoisoningsmaypresentwithearlyfindings in thefirst 2 hoursandlatefindingsbetween 6 hoursand 20 days. Renalfailurecan be seen in theacuteperiod in fungicontainingorellinandallenicnorleucine, andwithin 2-6 days in speciescontainingcyclopeptide. Patientsapplywithcomplaints of nausea, vomiting, diarrhea, unconsciousness in thefirst 3 daysafteringestion of mushroomscontainingnephrotoxin, andoliguriaandanuriawithin 3-20 days. Patientsmayneeddialysis in additiontosupportivetreatment. Inthisarticle, it wasaimedtoemphasizethatmushroompoisoningshould be considered in thedifferentialdiagnosis of renalfailureandcoma, as in thepatientwhosehistorywaslearnedtohaveeatenmushrooms 10 daysago. Twenty-nine-year-oldmalepatientwasbroughttotheemergencyroomduetodeterioration in his general conditionandunconsciousness. Inthepatient'shistory, therewerenauseaandvomitingaftereatingmushroomsabout 10 daysago, andantibioticinitiation in an externalcenter. On physicalexamination, the general conditionwaspoor, unconscious, and Glasgow comascalewas 7. Thepatientwho had suddencardiacarrest in theemergencydepartmentwasadmittedtotheintensivecareunitafterresuscitation. Thepatient'sbloodpressurewas 130/90 mmHg, pulse: 112/min, fever: 36.5 C, respiration: 36/min. Otherphysicalexaminationrevealednoabnormality. Inthelaboratorytests of thepatient: Hemoglobin 12.5, platelet 346, glucose 89, Urea 189, Creatinine 14, sodium 127, potassium 7.5, AspartatAminotransferaz 47, alaninAminotransferaz 13, Calcium 8.3, Troponin I 2.39, amylase 146, kreatin kinaz 1279, kreatin kinaz-MB 121, Gama glutamiltransferaz11, Lipase 35 andmetabolicacidosiswasdetected in bloodgas. Thepatientwastakentoemergencyhemodialysis. Hemodialysiswasappliedfor 3 days. Control bloodvalues 5-7. dayureawas 205-79, creatininewas 18-7.On the 7th day, thepatientwasextubated. On the 10th day, thepatientrecoveredcompletelyandwasdischargedvoluntarily. As a result of mushroompoisoning, lateclinicalkidneyfailure can be seen. Mushroompoisoningshould not be forgotten in patientsbroughttotheemergencyroomwithcoma. If it is not possibletofollow-upthesepatientsafterthecomplaintsthatoccur in thefirstdays, theyshould be informedaboutpossiblelatecomplications.Cultivatedmushroomsshould be preferredtopreventpoisoning

Keywords

• AcuteRenalFailure
• MushroomPoisoning
• Hemodialysis

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