HDCN Article Review/Hyperlink

Franz M, Regele H, Kirchmair M, Kletzmayr J, Sunder-Plassman G, Horl WH, Pohanka E

Magic mushrooms: hope for a 'cheap high' resulting in end-stage renal failure

Nephrol Dial Transplant (Nov) 11:2324-2327 1996

One of the first NEPHROL threads reproduced on HDCN pertains to the discussion of ARF after mushroom ingestion , particularly of the Cortinarius genus. On that thread, Dr. Kjellstrand describes his experience with "hippies" who would seek a magic mushroom high and would mistake Cortinarius genus mushrooms for the Psilocybe variety (Can Med Assoc J 147:1339- 1341, 1992.

This paper from Austria shows that the problem is arising once more. It cites a survey from Denmark purporting to show that 9% of students had exposure to psilocybin-containing mushrooms. The present paper describes the case of a 28 year old man with a 2 week history of N&V, and lumbar pain with proteinuria, leukocyturia, and erythrocyturia who presented with severe ARF. He was dialyzed, and a biopsy showed no glomerular pathology and non-specific tubular alterations. The patient was questioned further, admitted to ingesting mushrooms 1 week prior to onset of symptoms, and from looking at mushroom pictures, it became apparent that he had confused Cortinarius orellanoides mushrooms with those of the Psilocybe genus. Orellanine was later recovered 5 weeks later from a subsequent renal biopsy. The patient did not recover renal function, despite treatment with probucol, a free radical scavenger.

Comment: Something to keep in mind when confronted with unexplained renal failure in a truth-in-drugs seeking student type of patient. (John T. Daugirdas, M.D., University of Illinois at Chicago)