Herbal remedies containing aristolochic acid and mushroom nephrotoxicity

  • Frédéric Debelle
  • Marie-Carmen Muniz-Martinez
  • Jean-Louis Vanherweghem
  • Joëlle Nortier

Numerous myths have grown around medicinal herbs and their healing powers [1]. The myth of beneficent nature is resistant to the accumulated evidence of health problems resulting from unknown or underestimated toxicity as well as from adulteration and misidentification of medicinal herbs [2]. Many plants contain substances toxic to humans and therefore, not surprisingly, to the human kidney. In early 1993, a rapidly progressive kidney fail ure leading to end-stage renal disease was reported in a number of women who had ingested slimming pills that contained powdered Chinese herbs [3]. Further investigations showed that this so called “Chinese herb nephropathy” was, in fact, secondary to the replacement of one of the prescribed Chinese herb, Stephania tetrandra, by other mixtures of Chinese herbs containing Aristolochia Fang chi [4]. The term “Aristolochia nephropathy” was thus proposed to be used instead of “Chinese herb nephropathy (CHN)” [5]. Finally, due to the presence of aristolochic acids (AA) in Aristolochia spp. and to their further demonstrated nephrotoxicity (see below), the term of “Aristolochic acid nephropathy” (AAN) is now commonly used.


Herbal Remedy Chinese Herb Nephrol Dial Transplant Aristolochic Acid Fanconi Syndrome 
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  1. 1.
    Vanherweghem JL. Nephropathy and herbal medicine. Am J Kidney Dis 2000; 35: 330-332PubMedGoogle Scholar
  2. 2.
    Huxtable RJ. The myth of beneficent nature: the risks of herbal preparations. Ann Intern Med 1992; 117: 165-166PubMedGoogle Scholar
  3. 3.
    Vanherweghem JL, Depierreux M, Tielemans C, Abramowicz D, Dratwa M, Jadoul M, Richard C, Vandervelde D, Verbeelen D, Vanhaelen-Fastre R. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Lancet 1993; 341: 387-391PubMedGoogle Scholar
  4. 4.
    Vanhaelen M, Vanhaelen-Fastre R, But P, Vanherweghem JL. Identification of aristolochic acid in Chinese herbs. Lancet 1994; 343: 174 (letter)PubMedGoogle Scholar
  5. 5.
    Vanherweghem JL. Aristolochia nephropathy in humans: an outbreak in Belgium. J Am Soc Nephrol 1993; 4: 327 (abstract)Google Scholar
  6. 6.
    Vanherweghem JL. Misuse of herbal remedies: the case of an outbreak of terminal renal failure in Belgium (Chinese herbs ne-phropathy). J Altern Complement Med 1998; 4: 9-13PubMedGoogle Scholar
  7. 7.
    But PP. Need for correct identification of herbs in herbal poisoning. Lancet 1993; 341: 637 (letter)PubMedGoogle Scholar
  8. 8.
    Pourrat J, Montastruc JL, Lacombe JL, Cisterne JM, Rascol O, Dumazer P. Néphropathie associée à des herbes chinoises - 2 cas. Presse Med 1994; 23: 1669 (letter)PubMedGoogle Scholar
  9. 9.
    Stengel B, Jones E. Insuffisance rénale terminale associée à la consommation d’herbes chinoises en France. Néphrologie 1998; 19: 15-20PubMedGoogle Scholar
  10. 10.
    Pena JM, Borras M, Ramos J, Montoliu J. Rapidly progressive interstitial renal fibrosis due to a chronic intake of a herb (Aristolochia pistolochia) infusion. Nephrol Dial Transplant 1996; 11: 1359-1360PubMedGoogle Scholar
  11. 11.
    Lord GM, Tagore R, Cook T, Gower P, Pusey CD. Nephropathy caused by Chinese herbs in the UK. Lancet 1999; 354: 481-482PubMedGoogle Scholar
  12. 12.
    Cronin AJ, Maidment G, Cook T, Kite GC, Simmonds MS, Pusey CD, Lord GM. Aristolochic acid as a causative factor in a case of Chinese herbal nephropathy. Nephrol Dial Transplant 2002; 17: 524-525PubMedGoogle Scholar
  13. 13.
    Laing C, Hamour S, Sheaff M, Miller R, Woolfson R. Chinese herbal uropathy and nephropathy. Lancet 2006; 368: 338PubMedGoogle Scholar
  14. 14.
    Meyer MM, Chen TP, Bennett WM. Chinese herb nephropathy. Proc (Bayl Univ Med Cent) 2000; 13: 334-337Google Scholar
  15. 15.
    Yang CS, Lin CH, Chang SH, Hsu HC. Rapidly progressive fibrosing interstitial nephritis associated with Chinese herbal drugs. Am J Kidney Dis 2000; 35: 313-318PubMedGoogle Scholar
  16. 16.
    Chang CH, Wang YM, Yang AH, Chiang SS. Rapidly progressive interstitial renal fibrosis associated with Chinese herbal medica-tions. Am J Nephrol 2001; 21: 441-448PubMedGoogle Scholar
  17. 17.
    Tanaka A, Nishida R, Yokoi H, Kuwahara T. The characteristic pattern of aminoaciduria in patients with aristolochic acid-induced Fanconi syndrome: could iminoaciduria be the hallmark of this syndrome? Clin Nephrol 2000; 54: 198-202PubMedGoogle Scholar
  18. 18.
    Tanaka A, Nishida R, Maeda K, Sugawara A, Kuwahara T. Chinese herb nephropathy in Japan presents adult-onset Fanconi syndrome: could different components of aristolochic acids cause a different type of Chinese herb nephropathy? Clin Nephrol 2000; 53: 301-306PubMedGoogle Scholar
  19. 19.
    Krumme B, Endmeir R, Vanhaelen M, Walb D. Reversible Fanconi syndrome after ingestion of a Chinese herbal ‘remedy’ contain-ing aristolochic acid. Nephrol Dial Transplant 2001; 16: 400-402PubMedGoogle Scholar
  20. 20.
    Yang SS, Chu P, Lin YF, Chen A, Lin SH. Aristolochic acid-induced Fanconi’s syndrome and nephropathy presenting as hypokalemic paralysis. Am J Kidney Dis 2002; 39: E14PubMedGoogle Scholar
  21. 21.
    Tsai CS, Chen YC, Chen HH, Cheng CJ, Lin SH. An unusual cause of hypokalemic paralysis: aristolochic acid nephropathy with Fanconi syndrome. Am J Med Sci 2005; 330: 153-155PubMedGoogle Scholar
  22. 22.
    Lo SH, Mo KL, Wong KS, Poon SP, Chan CK, Lai CK, Chan A. Aristolochic acid nephropathy complicating a patient with focal segmental glomerulosclerosis. Nephrol Dial Transplant 2004; 19: 1913-1915PubMedGoogle Scholar
  23. 23.
    Yang L, Li X, Wang H. Possible mechanisms explaining the tendency towards interstitial fibrosis in aristolochic acid-induced acute tubular necrosis. Nephrol Dial Transplant 2007; 22: 445-456PubMedGoogle Scholar
  24. 24.
    van Ypersele de Strihou C, Vanherweghem JL. The tragic paradigm of Chinese herbs nephropathy. Nephrol Dial Transplant 1995; 10: 157-160PubMedGoogle Scholar
  25. 25.
    Kabanda A, Jadoul M, Lauwerys R, Bernard A, van Ypersele de Strihou C. Low molecular weight proteinuria in Chinese herbs nephropathy. Kidney Int 1995; 48: 1571-1576PubMedGoogle Scholar
  26. 26.
    Nortier JL, Deschodt-Lanckman MM, Simon S, Thielemans NO, de Prez EG, Depierreux MF, Tielemans CL, Richard C, Lauwerys RR, Bernard AM, Vanherweghem JL. Proximal tubular injury in Chinese herbs nephropathy: monitoring by neutral endopeptidase enzymuria. Kidney Int 1997; 51: 288-293PubMedGoogle Scholar
  27. 27.
    Vanherweghem JL, Abramowicz D, Tielemans C, Depierreux M. Effects of steroids on the progression of renal failure in chronic interstitial renal fibrosis: a pilot study in Chinese herbs nephropathy. Am J Kidney Dis 1996; 27: 209-215PubMedGoogle Scholar
  28. 28.
    Muniz Martinez MC, Nortier J, Vereerstraeten P, Vanherweghem JL. Steroid therapy in chronic interstitial renal fibrosis: the case of Chinese-herb nephropathy. Nephrol Dial Transplant 2002; 17: 2033-2034Google Scholar
  29. 29.
    Vanherweghem JL. Association of valvular heart disease with Chinese-herb nephropathy. Lancet 1997; 350: 1858 (letter)PubMedGoogle Scholar
  30. 30.
    Reginster F, Jadoul M, van Ypersele de Strihou C. Chinese herbs nephropathy presentation, natural history and fate after trans-plantation. Nephrol Dial Transplant 1997; 12: 81-86PubMedGoogle Scholar
  31. 31.
    Connolly HM, Crary JL, McGoon MD, Hensrud DD, Edwards BS, Edwards WD, Schaff HV. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med 1997; 337: 581-588PubMedGoogle Scholar
  32. 32.
    Unger P, Nortier J, Muniz Martinez MC, Plein D, Vandenbossche JL, Vereerstraeten P, Vanherweghem JL. High prevalence of fen-fluramine-related aortic regurgitation in women with end-stage renal disease secondary to Chinese herb nephropathy. Nephrol Dial Transplant 2003; 18: 906-910PubMedGoogle Scholar
  33. 33.
    Cosyns JP, Jadoul M, Squifflet JP, de Plaen JF, Ferluga D, van Ypersele de Strihou C. Chinese herbs nephropathy: a clue to Balkan endemic nephropathy? Kidney Int 1994; 45: 1680-1688PubMedGoogle Scholar
  34. 34.
    Depierreux M, Van Damme B, Vanden Houte K, Vanherweghem JL. Pathologic aspects of a newly described nephropathy related to the prolonged use of Chinese herbs. Am J Kidney Dis 1994; 24: 172-180PubMedGoogle Scholar
  35. 35.
    Jadoul M, de Plaen JF, Cosyns JP, van Ypersele de Strihou C. Adverse effects from traditional Chinese medicine. Lancet 1993; 341: 892-893PubMedGoogle Scholar
  36. 36.
    Cosyns JP, Jadoul M, Squifflet JP, Van Cangh PJ, van Ypersele de Strihou C. Urothelial malignancy in nephropathy due to Chinese herbs. Lancet 1994; 344: 188 (letter)PubMedGoogle Scholar
  37. 37.
    Vanherweghem JL, Tielemans C, Simon J, Depierreux M. Chinese herbs nephropathy and renal pelvic carcinoma. Nephrol Dial Transplant 1995; 10: 270-273PubMedGoogle Scholar
  38. 38.
    Lord GM, Cook T, Arlt VM, Schmeiser HH, Williams G, Pusey CD. Urothelial malignant disease and Chinese herbal nephropathy. Lancet 2001; 358: 1515-1516PubMedGoogle Scholar
  39. 39.
    Cosyns JP, Jadoul M, Squifflet JP, Wese FX, van Ypersele de Strihou C. Urothelial lesions in Chinese-herb nephropathy. Am J Kidney Dis 1999; 33: 1011-1017PubMedGoogle Scholar
  40. 40.
    Nortier JL, Muniz Martinez MC, Schmeiser HH, Arlt VM, Bieler CA, Petein M, Depierreux MF, De Pauw L, Abramowicz D, Vereer-straeten P, Vanherweghem JL. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med 2000; 342: 1686-1692PubMedGoogle Scholar
  41. 41.
    Lemy A, Wissing KM, Rorive S, Zlotta A, Roumeguere T, Muniz Martinez MC, Decaestecker C, Salmon I, Abramowicz D, Vanher-weghem JL, Nortier J. Late onset of bladder urothelial carcinoma after kidney transplantation for end-stage aristolochic acid nephropathy: a case series with 15-year follow-up. Am J Kidney Dis 2008; 51: 471-477PubMedGoogle Scholar
  42. 42.
    Nortier JL, Schmeiser HH, Muniz Martinez MC, Arlt VM, Vervaet C, Garbar CH, Daelemans P, Vanherweghem JL. Invasive urothe-lial carcinoma after exposure to Chinese herbal medicine containing aristolochic acid may occur without severe renal failure. Nephrol Dial Transplant 2003; 18: 426-428PubMedGoogle Scholar
  43. 43.
    Stefanovic V, Polenakovic MH. Balkan nephropathy. Kidney disease beyond the Balkans? Am J Nephrol 1991; 11: 1-11PubMedGoogle Scholar
  44. 44.
    Mengs U. Acute toxicity of aristolochic acid in rodents. Arch Toxicol 1987; 59: 328-331PubMedGoogle Scholar
  45. 45.
    Jackson L, Kofman S, Weiss A, Brodovsky H. Aristolochic Acid (NSC-50413): Phase I Clinical Study. Cancer Chemotherapy Reports 1964; 35-37Google Scholar
  46. 46.
    Mengs U, Lang W, Poch J-A. The carcinogenic action of aristolochic acid in rats. Arch Toxicol 1982; 57: 107-119Google Scholar
  47. 47.
    Malak J. Chinese herb nephropathy is not a (dex)fenfluramine nephropathy but a serotonin nephropathy. J Altern Complement Med 1998; 4: 131-132PubMedGoogle Scholar
  48. 48.
    McIntyre M. Chinese herbs: risk, side effects, and poisoning: the case for objective reporting and analysis reveals serious mis-representation. J Altern Complement Med 1998; 4: 15-16PubMedGoogle Scholar
  49. 49.
    Colson CR, De Greef KE, Duymelinck C, Simoens PJ, Verpooten GA, De Broe ME. Role of serotonin in the development of Chinese herbs nephropathy? Nephrol Dial Transplant 1999; 14 Suppl 4: 16 (abstract)PubMedGoogle Scholar
  50. 50.
    De Broe ME. On a nephrotoxic and carcinogenic slimming regimen. Am J Kidney Dis 1999; 33: 1171-1173PubMedGoogle Scholar
  51. 51.
    Schmeiser HH, Bieler CA, Wiessler M, van Ypersele de Strihou C, Cosyns JP. Detection of DNA adducts formed by aristolochic acid in renal tissue from patients with Chinese herbs nephropathy. Cancer Res 1996; 56: 2025-2028PubMedGoogle Scholar
  52. 52.
    Bieler CA, Stiborova M, Wiessler M, Cosyns JP, van Ypersele de Strihou C, Schmeiser HH. 32P-post-labelling analysis of DNA adducts formed by aristolochic acid in tissues from patients with Chinese herbs nephropathy. Carcinogenesis 1997; 18: 1063-1067PubMedGoogle Scholar
  53. 53.
    Muniz Martinez MC, Nortier J, Vereerstraeten P, Vanherweghem JL. Progression rate of Chinese herb nephropathy: impact of Aristolochia fangchi ingested dose. Nephrol Dial Transplant 2002; 17: 408-412Google Scholar
  54. 54.
    Gillerot G, Jadoul M, Arlt VM, van Ypersele de Strihou C, Schmeiser HH, But PP, Bieler CA, Cosyns JP. Aristolochic acid nephropathy in a Chinese patient: time to abandon the term “Chinese herbs nephropathy”? Am J Kidney Dis 2001; 38: E26PubMedGoogle Scholar
  55. 55.
    Vanherweghem JL, Cuykens JJ, Vandenbergh P, Bouman KP, Hagers Y. Valvular heart disease and Chinese-herb nephropathy. Lancet 1998; 351: 991Google Scholar
  56. 56.
    Debelle F, Nortier J, Arlt VM, De Prez E, Vienne A, Salmon I, Phillips DH, Deschodt-Lanckman M, Vanherweghem JL. Effects of dexfenfluramine on aristolochic acid nephrotoxicity in a rat model for Chinese-herb nephropathy. Arch Toxicol 2003; 77: 218-226PubMedGoogle Scholar
  57. 57.
    Stiborova M, Frei E, Wiessler M, Schmeiser HH. Human enzymes involved in the metabolic activation of carcinogenic aristolochic acids: evidence for reductive activation by cytochromes P450 1A1 and 1A2. Chem Res Toxicol 2001; 14: 1128-1137PubMedGoogle Scholar
  58. 58.
    Stiborova M, Frei E, Breuer A, Wiessler M, Schmeiser HH. Evidence for reductive activation of carcinogenic aristolochic acids by prostaglandin H synthase -- (32)P-postlabeling analysis of DNA adduct formation. Mutat Res 2001; 493: 149-160PubMedGoogle Scholar
  59. 59.
    Schmeiser HH, Scherf HR, Wiessler M. Activating mutations at codon 61 of the c-Ha-ras gene in thin-tissue sections of tumors induced by aristolochic acid in rats and mice. Cancer Lett 1991; 59: 139-143PubMedGoogle Scholar
  60. 60.
    Lebeau C, Arlt VM, Schmeiser HH, Boom A, Verroust PJ, Devuyst O, Beauwens R. Aristolochic acid impedes endocytosis and induces DNA adducts in proximal tubule cells. Kidney Int 2001; 60: 1332-1342PubMedGoogle Scholar
  61. 61.
    Cosyns JP, Goebbels RM, Liberton V, Schmeiser HH, Bieler CA, Bernard AM. Chinese herbs nephropathy-associated slimming regimen induces tumours in the forestomach but no interstitial nephropathy in rats. Arch Toxicol 1998; 72: 738-743PubMedGoogle Scholar
  62. 62.
    Cosyns JP, Dehoux JP, Guiot Y, Goebbels RM, Robert A, Bernard AM, van Ypersele de Strihou C. Chronic aristolochic acid toxicity in rabbits: A model of Chinese herbs nephropathy? Kidney Int 2001; 59: 2164-2173Google Scholar
  63. 63.
    Debelle FD, Nortier JL, de Prez EG, Garbar CH, Vienne AR, Salmon IJ, Deschodt-Lanckman MM, Vanherweghem JL. Aristolochic acids induce chronic renal failure with interstitial fibrosis in salt-depleted rats. J Am Soc Nephrol 2002; 13: 431-436PubMedGoogle Scholar
  64. 64.
    Debelle FD, Nortier JL, Husson CP, de Prez EG, Vienne AR, Rombaut K, Salmon IJ, Deschodt-Lanckman M, Vanherweghem JL. The renin-angiotensin system blockade does not prevent renal interstitial fibrosis induced by aristolochic acids. Kidney Int 2004; 66: 1815-1825PubMedGoogle Scholar
  65. 65.
    Sato N, Takahashi D, Chen SM, Tsuchiya R, Mukoyama T, Yamagata S, Ogawa M, Yoshida M, Kondo S, Satoh N, Ueda S. Acute nephrotoxicity of aristolochic acids in mice. J Pharm Pharmacol 2004; 56: 221-229PubMedGoogle Scholar
  66. 66.
    Balachandran P, Wei F, Lin RC, Khan IA, Pasco DS. Structure activity relationships of aristolochic acid analogues: toxicity in cultured renal epithelial cells. Kidney Int 2005; 67: 1797-1805PubMedGoogle Scholar
  67. 67.
    Pozdzik AA, Salmon IJ, Debelle FD, Decaestecker C, Van den Branden C, Verbeelen D, Deschodt-Lanckman MM, Vanherweghem JL, Nortier JL. Aristolochic acid induces proximal tubule apoptosis and epithelial to mesenchymal transformation. Kidney Int 2008; 73: 595-607PubMedGoogle Scholar
  68. 68.
    Okada H, Watanabe Y, Inoue T, Kobayashi T, Kanno Y, Shiota G, Nakamura T, Sugaya T, Fukamizu A, Suzuki H. Transgene-derived hepatocyte growth factor attenuates reactive renal fibrosis in aristolochic acid nephrotoxicity. Nephrol Dial Transplant 2003; 18: 2515-2523PubMedGoogle Scholar
  69. 69.
    Lebeau C, Debelle FD, Arlt VM, Pozdzik A, de Prez EG, Phillips DH, Deschodt-Lanckman MM, Vanherweghem JL, Nortier JL. Early proximal tubule injury in experimental aristolochic acid nephropathy: functional and histological studies. Nephrol Dial Transplant 2005; 20: 2321-2332PubMedGoogle Scholar
  70. 70.
    Liu MC, Maruyama S, Mizuno M, Morita Y, Hanaki S, Yuzawa Y, Matsuo S. The nephrotoxicity of Aristolochia manshuriensis in rats is attributable to its aristolochic acids. Clin Exp Nephrol 2003; 7: 186-194PubMedGoogle Scholar
  71. 71.
    Hsin YH, Cheng CH, Tzen JT, Wu MJ, Shu KH, Chen HC. Effect of aristolochic acid on intracellular calcium concentration and its links with apoptosis in renal tubular cells. Apoptosis 2006; 11: 2167-2177PubMedGoogle Scholar
  72. 72.
    Lee S, Lee T, Lee B, Choi H, Yang M, Ihm CG, Kim M. Fanconi‘s syndrome and subsequent progressive renal failure caused by a Chinese herb containing aristolochic acid. Nephrology (Carlton ) 2004; 9: 126-129Google Scholar
  73. 73.
    Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Muta-genesis 2002; 17: 265-277Google Scholar
  74. 74.
    Vanherweghem JL. Urémie chronique et cancer des voies urinaires secondaires à la prise d’extraits végétaux utilisés en phy-tothérapie chinoise. Med Sciences 2003; 18: 1095-1101Google Scholar
  75. 75.
    Zhu M, Phillipson JD. Hong Kong samples of the traditional Chinese Medicine “Fang ji” contain aristolochic acid toxins. Int J Pharmacognosy 1996; 34: 283-289Google Scholar
  76. 76.
    Hashimoto K, Higuchi M, Makino B, Sakakibara I, Kubo M, Komatsu Y, Maruno M, Okada M. Quantitative analysis of aristolochic acids, toxic compounds, contained in some medicinal plants. J Ethnopharmacol 1999; 64: 185-189PubMedGoogle Scholar
  77. 77.
    Vanherweghem JL. Aristolochia sp and chronic interstitial nephropathies in Indians. Lancet 1997; 349: 1399PubMedGoogle Scholar
  78. 78.
    Grollman AP, Shibutani S, Moriya M, Miller F, Wu L, Moll U, Suzuki N, Fernandes A, Rosenquist T, Medverec Z, Jakovina K, Brdar B, Slade N, Turesky RJ, Goodenough AK, Rieger R, Vukelić M, Jelaković B. Aristolochic acid and the etiology of endemic (Balkan) nephropathy. Proc Natl Acad Sci 2007;104:12129-12134PubMedGoogle Scholar
  79. 79.
    Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: a worldwide problem. Kidney Int 2008; in pressGoogle Scholar
  80. 80.
    Lewis CJ, Alpert S. Letter to health Care Professionals on FDA concerned about botanical products, including dietary supple-ments containing aristolochic acid. Us Food and Drug Administration - Center for Food Safety and Applied Nutrition - Office of Natritional Products. Labeling and Dietary supplements 2000; May 31Google Scholar
  81. 81.
    World Health Organization - International Agency for research on cancer: IARC monographs on the evaluation of carcinogenic risks to humans: some traditional herbal medicines, some mycotoxins, naphtalene and styrene. IARC Press, Lyon, France 2002; 82: 118Google Scholar
  82. 82.
    Wieland T. The toxic peptides from Amanita mushrooms. Int J Pept Protein Res 1983; 22: 257-276PubMedCrossRefGoogle Scholar
  83. 83.
    Karlson-Stiber C, Persson H. Cytotoxic fungi--an overview. Toxicon 2003; 42: 339-349PubMedGoogle Scholar
  84. 84.
    Jehl F, Gallion C, Birckel P, Jaeger A, Flesch F, Minck R. Determination of alpha-amanitin and beta-amanitin in human biological fluids by high-performance liquid chromatography. Anal Biochem 1985; 149: 35-42PubMedGoogle Scholar
  85. 85.
    Jaeger A, Jehl F, Flesch F, Sauder P, Kopferschmitt J. Kinetics of amatoxins in human poisoning: therapeutic implications. J Toxicol Clin Toxicol 1993; 31: 63-80PubMedGoogle Scholar
  86. 86.
    Mullins ME, Horowitz BZ. The futility of hemoperfusion and hemodialysis in Amanita phalloides poisoning. Vet Hum Toxicol 2000; 42: 90-91PubMedGoogle Scholar
  87. 87.
    Enjalbert F, Rapior S, Nouguier-Soule J, Guillon S, Amouroux N, Cabot C. Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol 2002; 40: 715-757PubMedGoogle Scholar
  88. 88.
    Danel VC, Saviuc PF, Garon D. Main features of Cortinarius spp. poisoning: a literature review. Toxicon 2001; 39: 1053-1060PubMedGoogle Scholar
  89. 89.
    Prast H, Werner ER, Pfaller W, Moser M. Toxic properties of the mushroom Cortinarius orellanus. I. Chemical characterization of the main toxin of Cortinarius orellanus (Fries) and Cortinarius speciosissimus (Kuhn & Romagn) and acute toxicity in mice. Arch Toxicol 1988; 62: 81-88PubMedGoogle Scholar
  90. 90.
    Bouget J, Bousser J, Pats B, Ramee MP, Chevet D, Rifle G, Giudicelli CP, Thomas R. Acute renal failure following collective intoxica-tion by Cortinarius orellanus. Intensive Care Med 1990; 16: 506-510PubMedGoogle Scholar
  91. 91.
    Short AI, Watling R, MacDonald MK, Robson JS. Poisoning by Cortinarius speciosissimus. Lancet 1980; 2: 942-944PubMedGoogle Scholar
  92. 92.
    Gryzmala S. Massenvergiftungen durch den orangefuchsigen Hautkopf. Z Pilzkd 1957; 23: 139-142Google Scholar
  93. 93.
    Mount P, Harris G, Sinclair R, Finlay M, Becker GJ. Acute renal failure following ingestion of wild mushrooms. Intern Med J 2002; 32: 187-190PubMedGoogle Scholar
  94. 94.
    Montoli A, Confalonieri R, Colombo V. Lack of efficacy of early plasma exchange in renal toxicity from Cortinarius orellanus. Nephron 1999; 81: 248PubMedGoogle Scholar
  95. 95.
    Calvino J, Romero R, Pintos E, Novoa D, Guimil D, Cordal T, Mardaras J, Arcocha V, Lens XM, Sanchez-Guisande D. Voluntary inges- tion of Cortinarius mushrooms leading to chronic interstitial nephritis. Am J Nephrol 1998; 18: 565-569PubMedGoogle Scholar
  96. 96.
    O‘Donnell M, Fleming S. The renal pathology of mushroom poisoning. Histopathology 1997; 30: 280-282PubMedGoogle Scholar
  97. 97.
    Rapior S, Delpech N, Andary C, Huchard G. Intoxication by Cortinarius orellanus: detection and assay of orellanine in biological fluids and renal biopsies. Mycopathologia 1989; 108: 155-161PubMedGoogle Scholar
  98. 98.
    Kilner RG, D‘Souza RJ, Oliveira DB, MacPhee IA, Turner DR, Eastwood JB. Acute renal failure from intoxication by Cortinarius orel- lanus: recovery using anti-oxidant therapy and steroids. Nephrol Dial Transplant 1999; 14: 2779-2780PubMedGoogle Scholar
  99. 99.
    Wornle M, Angstwurm MW, Sitter T. Treatment of intoxication with Cortinarius speciosissimus using an antioxidant therapy. Am J Kidney Dis 2004; 43: e3-e6PubMedGoogle Scholar
  100. 100.
    de Haro L, Jouglard J, Arditti J, David JM. Insuffisance rénale aiguë lors d’intoxications par Amanita proxima: expérience du Centre anti-poisons de Marseille. Néphrologie 1998; 19: 21-24PubMedGoogle Scholar
  101. 101.
    Leray H, Canaud B, Andary C, Klouche K, Beraud JJ, Mion C. Intoxication par Amanita proxima; une nouvelle cause d’insuffisance rénale aiguë. Néphrologie 1994; 15: 197-199PubMedGoogle Scholar
  102. 102.
    Pelizarri V, Feifel E, Rohrmoser MM, Gstraunthaler G, Moser M. Partial purification and characterization of a toxic component of Amanita smithiana. Mycologia 1994; 86: 555-560Google Scholar
  103. 103.
    Yang WS, Lin CH, Huang JW, Fang CC. Acute renal failure caused by mushroom poisoning. J Formos Med Assoc 2006; 105: 263-267PubMedGoogle Scholar
  104. 104.
    Leathem AM, Purssell RA, Chan VR, Kroeger PD. Renal failure caused by mushroom poisoning. J Toxicol Clin Toxicol 1997; 35: 67-75PubMedGoogle Scholar
  105. 105.
    Bedry R, Baudrimont I, Deffieux G, Creppy EE, Pomies JP, Ragnaud JM, Dupon M, Neau D, Gabinski C, De WS, Chapalain JC, Godeau P, Beylot J. Wild-mushroom intoxication as a cause of rhabdomyolysis. N Engl J Med 2001; 345: 798-802PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Frédéric Debelle
    • 1
  • Marie-Carmen Muniz-Martinez
    • 1
  • Jean-Louis Vanherweghem
    • 1
  • Joëlle Nortier
    • 1
  1. 1.Nephrology DepartmentErasme Hospital, Université Libre de BruxellesBrusselsBelgium

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