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ACUTE RENAL FAILURE AFTER INTAKE OF MUSHROOMS.
Insuficiencia renal aguda tras consumo de setas
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La recolección y consumo de setas silvestres es una práctica frecuente en nuestro medio y puede dar lugar a intoxicaciones accidentales al ser confundidas con hongos comestibles. Describimos el caso de un niño de 9 años que tras la ingesta de un hongo tóxico comienza horas después con vómitos incoercibles y posterior afectación hepática, hematológica y renal, precisando hemodiálisis. El curso clínico, los hallazgos de laboratorio y la histología renal, donde se evidencia necrosis tubular con membrana basal conservada e infiltrado linfocitario intersticial, confirman el diagnóstico de un síndrome mixto grave. La evolución de la intoxicación fue favorable, recuperándose la función renal y hepática. Ante cualquier caso de insuficiencia renal aguda no filiada en niños, habría que descartar la exposición a tóxicos, ya que podría beneficiarse de un tratamiento precoz con hemoperfusión y así evitar el agravamiento de la función renal y resto de órganos. En nuestro paciente la hemoperfusión no fue realizada por el largo período de latencia que había ocurrido desde la ingesta del tóxico hasta su diagnóstico.
Palabras clave:
Setas
Palabras clave:
Necrosis tubular aguda
Palabras clave:
Insuficiencia renal aguda
Palabras clave:
Pediatría
Palabras clave:
Plantas tóxicas
The picking and consumption of wild mushrooms is a frequent practice in our region and may lead to accidental poisoning when confused with edible mushrooms. We describe the case of a 9-year-old boy who, following the ingestion of a poisonous mushroom, presented with uncontrollable vomiting and subsequent hepatic, haematological and renal failure some hours later. The patient required haemodialysis. The clinical course, laboratory findings and renal histology, which showed tubular necrosis with basal membrane preserved and lymphocytic interstitial infiltrate, confirmed the diagnosis of a severe mixed syndrome. The patient evolved favourably after the poisoning, recovering renal and liver function. In any case of acute renal failure of unknown cause in children, it would be necessary to rule out ingestion of mushrooms, since the patient could benefit from early treatment with haemoperfusion and thus prevent the deterioration of the renal function and other organs. In our patient, haemoperfusion was not carried out due to the lengthy period of latency since the ingestion of the toxic substance until diagnosis.
Keywords:
Mushrooms
Keywords:
Kidney tubular necrosis
Keywords:
Acute renal failure
Keywords:
Pediatrics
Keywords:
Plants toxic