Orellanine Mushroom Toxicity Workup

Updated: Aug 21, 2014
  • Author: Reed Brozen, MD; Chief Editor: Asim Tarabar, MD  more...
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Workup

Laboratory Studies

See the list below:

  • Obtain electrolytes, BUN, creatinine, and glucose levels.
  • Administer liver function tests.
  • Consider CBC and coagulation studies. Findings may be normal, but anemia may be observed with prolonged renal insufficiency and coagulopathy may complicate uremia.
  • On urinalysis, microscopic hematuria and leukocyturia is common. Gross hematuria is rare. Albuminuria may be present.
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Other Tests

A 12-lead electrocardiogram is useful if hyperkalemia or other comorbidities 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, it is unlikely that gastric specimens will 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.

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