Nolte S, Hufschmidt C, Steinhauer H, Rohrbach R, Künzer W
Monatsschr Kinderheilkd. 1987 May;135(5):280-1.
A 14 year old boy was admitted for vomiting, anorexia, flank pain and leukocyturia/hematuria. Shortly after admission, he developed anuria and acute renal failure so that hemodialysis had to be started. Pre- and post-renal causes were excluded. There were no signs of acute glomerulonephritis; liver enzymes were normal. The 123Iodine-Hippuran scan showed a shock kidney pattern lacking tubular clearance. Renal biopsy revealed an interstitial nephritis with edema and a mixed cellular infiltration. History was empty for nephrotoxic agents except for mushroom ingestion: Five days before admission the boy ate Cortinarius speciocissimus mushrooms, the toxine of which is known to be nephrotoxic, causing irreversible renal failure in severe cases (Orellanus Syndrome). Renal function did not improve much and renal transplantation was performed after 14 months on hemodialysis. In interstitial nephritis of unknown etiology the possibility of mushroom poisoning should be considered.
一名14岁男孩因呕吐、厌食、胁腹疼痛及白细胞尿/血尿入院。入院后不久，他出现无尿和急性肾衰竭，因此不得不开始血液透析。肾前性和肾后性病因均被排除。没有急性肾小球肾炎的迹象；肝酶正常。123碘-马尿酸扫描显示为休克肾模式，缺乏肾小管清除功能。肾活检显示为间质性肾炎，伴有水肿和混合性细胞浸润。除了食用蘑菇外，没有肾毒性药物接触史：入院前五天，该男孩食用了华美丝膜菌，已知其毒素具有肾毒性，严重时可导致不可逆的肾衰竭（奥雷拉努斯综合征）。肾功能改善不大，血液透析14个月后进行了肾移植。在病因不明的间质性肾炎中，应考虑蘑菇中毒的可能性。
