Laboratory confirmation of Cortinarius poisoning

International audienceDeliberate poisoning with Cortinarius orellanus. Identification of orellanine in renal biopsy ten days and 6 months after the toxic mushroom ingestio

Intoxication by Cortinarius orellanus: detection and assay of orellanine in biological fluids and renal biopsies

International audienceA woman suffering from acute tubulo-interstitial nephritis was admitted to the hospital ten days after deliberate intoxication by ingestion of Cortinarius orellanus. Orellanine, the main toxin responsible for orellanine poisoning, was detected in biological fluids and renal biopsies. It was assayed by direct spectrofluorimetry on two-dimensional thin-layer chromatograms after specific photodecomposition into orelline. The orellanine concentration was 6.12 mg/l in the plasma (10 days after ingestion). Orellanine levels in renal biopsies were 7 micrograms per 25 mm3 of the first biopsy (13 days after ingestion) and 24 micrograms per 8 mm3 of the second biopsy (6 months later)

Blood purification after orellanine intoxication with Cortinarius orellanus

International audienc

Intérêt d'un traitement précoce original dans un cas d'intoxication volontaire par Cortinarius orellanus après dosage de l'orellanine dans les milieux biologiques et tissulaires

International audienceCortinarius poisoning is generally caused by orellanine, a hydroxy bipyridine N, N-dioxide. This intoxication is characterized by acute nephritis which can lead to death without treatment. We reported a highly sensitive and simple fluorimetric technique to analyse orellanine by thin-layer chromatography on the basis of its characteristic photodecomposition into orelline. Using this procedure, we detected and assayed orellanine for the first time in plasma and renal biopsies of a woman who had deliberately ingested two fruit-bodies of Cortinarius orellanus. An early original treatment was carried out based on hemodialysis, combination plasmapheresis-hemoperfusion, and amino acids and diltiazem administration. These results indicate that it is now possible to make a precise diagnosis of orellanine poisoning