Laboratory Studies
Blood studies may include the following:
-
Electrolytes, blood urea nitrogen (BUN), creatinine, and glucose levels
-
Liver function studies
-
Complete blood cell count and coagulation studies. Findings may be normal, but anemia may be observed with prolonged kidney insufficiency and coagulopathy may complicate uremia. Animal studies of orellanine poisoning reported thrombocytopenia and white blood cell changes including neutrophilia, lymphopenia, and eosinopenia. [4]
On urinalysis, microscopic hematuria and leukocyturia is common. Gross hematuria is rare. Albuminuria may be present.
Other Tests
A 12-lead electrocardiogram is useful if hyperkalemia or other comorbidity is suspected.
Assistance by an experienced mycologist is essential for mushroom identification. A regional poison center or local university may be able to assist in this regard. A reference lab may be able to test for orellanine if a food specimen is available.
Since a considerable delay between ingestion and presentation (days) usually exists, gastric specimens are unlikely to be of any use. Examine for mushroom type or orellanine toxin if any prepared food is still available. It may be possible to have additional mushrooms collected and identified if patient is able to describe area where the mushrooms were foraged.
