Orellani

Orellanine is a potent mycotoxin primarily found in mushrooms belonging to the Cortinarius genus, notably Cortinarius orellanus and Cortinarius rubellus. This toxin is responsible for causing Orellanus Syndrome, a serious condition characterized by initial symptoms of nausea, vomiting, and thirst, followed by kidney failure several days after ingestion. Due to its delayed toxic effects, orellanine poisoning is particularly dangerous and can lead to severe health complications or even death if not treated promptly.

Symptoms and Diagnosis

The initial symptoms of orellanine poisoning include gastrointestinal distress, such as nausea and vomiting, which can occur several hours to a few days after ingestion of the toxic mushrooms. These early symptoms are often followed by a deceptive period of apparent recovery, before the onset of more severe symptoms related to kidney damage, including oliguria (reduced urine output), anuria (absence of urine production), and signs of acute kidney injury. Diagnosis of orellanine poisoning is primarily based on the history of mushroom consumption, clinical symptoms, and laboratory findings indicating renal impairment.

Treatment

There is no specific antidote for orellanine poisoning. Treatment is mainly supportive and focuses on managing symptoms and preventing further kidney damage. This may include hydration therapy to maintain fluid balance, dialysis in cases of significant kidney failure, and monitoring and treatment of any complications that arise. Early medical intervention is crucial to improve the prognosis of affected individuals.

Prevention

Prevention of orellanine poisoning is primarily through education and awareness about the risks of foraging and consuming wild mushrooms. Mushroom gatherers should be thoroughly familiar with the species they collect and consume, avoiding any mushrooms that could potentially be confused with Cortinarius species. Additionally, consulting with local mycological societies or experts can help in identifying safe mushrooms.

Epidemiology

Orellanine poisoning is relatively rare but has been reported in various parts of Europe and Asia, where Cortinarius mushrooms are found. The incidence of poisoning is higher during the mushroom foraging season, particularly among individuals who engage in this activity without adequate knowledge of mushroom species.

See Also

• Mycotoxicology
• Mushroom poisoning
• Renal failure