Three cases of mushroom poisoning with an unexpected initial presentation: acute kidney injury with Amanita proxima poisoning


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AYDIN M. B., GÖKTUĞ M. R., ORUÇ A., YILDIZ A., ÖZERİK K., ASLAN H., ...More

Renal Replacement Therapy, vol.9, no.1, 2023 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 9 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1186/s41100-023-00515-x
  • Journal Name: Renal Replacement Therapy
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Keywords: Acute kidney injury, Amanita nephrotoxic syndrome, Amanita proxima, Mushroom poisoning, Nephrotoxicity
  • Bursa Uludag University Affiliated: Yes

Abstract

Background: Mushroom poisoning causes common gastrointestinal symptoms such as nausea and vomiting and is a well-known reason for acute hepatic failure. Acute kidney injury is a less common clinical presentation in mushroom poisoning. Recently, nephrotoxicity called Amanita nephrotoxic syndrome has been defined, caused by several Amanita mushrooms. It is characterized by moderate hepatotoxicity and oligoanuric acute kidney injury, which may require hemodialysis. Case presentation: Case 1 was a 51-year-old female patient who was hospitalized with oliguria, nausea, and vomiting after eating mushrooms, required hemodialysis due to acute kidney injury, and developed pulmonary hemorrhage during her follow-up. Case 2 was a 55-year-old male patient who was hospitalized with anuria, nausea, and vomiting after eating mushrooms, required hemodialysis due to acute kidney injury, and developed acute coronary syndrome during his follow-up. Case 3 was a 59-year-old male patient who was hospitalized with oliguria, nausea, and vomiting after eating mushrooms, required hemodialysis due to acute kidney injury, and developed moderate hepatotoxicity during his follow-up. All cases were hospitalized at the same time interval with similar clinical features. Acute kidney injury was the initial presentation of all the cases, and they had only mild transaminase elevation with normal INR levels. They all required hemodialysis, and kidney injury was fully recovered. Conclusions: Mushroom consumption must be questioned in acute kidney injury patients of unknown etiology where mushrooms are habitual despite deleterious consequences.