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Cortinarius speciosissimus
General Details, Taxonomy and Biology, Clinical Effects, First Aid
Cortinarius  speciosissimus (  )  [ Original photo copyright © Irene Andersson ]
Phylum: Basidiomycota
Class: Basidiomycetes
Order: Agaricales
Family: Cortinariaceae
Genus: Cortinarius
Species: speciosissimus
Clinical Group: GROUP 1 - Cytotoxic mushroom poisoning
Often gregarious rarely solitary. Found on nutrient poor acid soils in sub-alpine coniferous forests.
PILEUS (cap) 1.5-7 cm diameter. Bell shaped to convex then plano-convex, often acutely umbonate with age, sometimes conical. Surface evenly reddish orange to reddish brown, sometimes cracked, dry, dull, unpolished, covered with silky hairs, sometimes minutely scaly. Margin in-rolled to in-curved at first with a cortina, becoming plane, even or sometimes scalloped with grooves, wrinkled, sometimes decorated with reddish brown veil fibrils.

LAMELLAE (gills) adnexed, close to sub-distant or distant, ascending to curved. About 3 mm broad, inflated on one side, edges straight, even and entire. Caramel, yellow brown, orange brown or reddish brown to dark rusty brown, sometimes with rusty brown spots.

STIPE (stem) 4-10 cm in height, 0.5-1.5 cm thick. Cylindrical to clavate, sometimes sub-bulbous at base, solid. Surface silky fibrillose, dry, reddish orange with light yellow wooly bands, more yellowish at the apex.

CORTINA is cobweb-like, light yellow or bright orange.

FLESH of pileus light yellow when young, yellowish orange when old, thicker in the center of pileus, thinner towards the margin. Flesh of stipe light yellow to bright orange.

SPORE PRINT brownish gold.

Spores 9.6 by 7.6 μm, broadly elliptical, amygdaliform to oval, moderately verrucose and light yellowish in colour.
Basidia clavate, 36-40 x 9-11 μm, with 4 sterigmata and a basal clamp.
First Aid
Description: First aid for poisoning by plants or mushrooms where no agreed first aid method is currently available.
In the absence of research or clinical data about first aid for poisoning caused by this species, no first aid method can currently be recommended. Seek Medical Advice without delay.
Clinical Effects & Treatment
Clinical Classification
Group 1C - Delayed primary nephrotoxicity
Contains orellanine and cortinarin.

A polypeptide nephrotoxic toxin (cortinarin A) has been isolated, In addition cortinarin B and cortinarin C were also isolated. It has been found that cortinarin B and C are nephrotoxic in laboratory animals. Cortinarin A and B shows blue fluorescence under UV light. Concentration of cortinarin A in C. rubellus was 0.47% of dry weight and cortinarin B was 0.60% w/w.

The substance isolated from C. speciosissimus was very pure and homogeneous. The suggested structure for this compound is 3,3',4,4'-tetrahydroxy-2,2'-bipyridine-N,N'-dioxide(Antkowiak and Gessner), however this structure is disputed by some. The LD50 in mice is 20 mg/kg. It caused interstitial nephritis and tubular necrosis after i.p administration of the toxin.

About 0.27 pg/ spore of orellanine has been found in C. rubellus spore. The percentage of orellanine in C. rubellus cap and stem were 0.8% and 0.4%.

Orellanine is a homogeneous substance which decomposes under the influence of light (UV light or day light) it will break down in to orellinine and a non-toxic product orelline. Oxygen has no detectable effect on the toxin.
Both orellanine and orelline were bipyridines occuring in two tautomeric configurations.
It is a colourless, polar, blue-fluorescing compound, somewhat unstable; it yields the non toxic orelline, slowly at 150 degrees and explosively at 267 degrees.

Molecular weight is 252.039
Molecular formula is C10H10O6N2

Orellanine is a nephrotoxin. It has also been found that the toxin found in C. orellanus inhabits DNA depended RNA polymerase B from rat liver and DNA depended RNA polymerase from Ecoli.

Clinical Effects Overview
Poisoning by ingestion of nephrotoxic mushrooms (specifically Cortinarius spp.) results in delayed onset of renal damage, with a latent period of 36hrs to 17 days before onset of symptoms (shorter delay associated with more severe renal damage).

Following the symptom-free latent period, there may be a varied mixture of symptoms prior to onset of renal failure. These "prerenal" symptoms may last up to a week and can include gastrointestinal effects (nausea, vomiting, thirst, anorexia), neurologic effects (headache, chills, shivering, parastheseae, tinnitus, drowsiness, coma), non-specific (sweats, generalised rash, dyspnoea, lumbar pain).

Following the "prerenal" symptoms, there is onset of renal failure, usually commencing with a polyuric phase, then (in more significant cases), oliguric or anuric renal failure, with slow recovery over weeks in some cases, but with permanent renal failure in a minority of cases, requiring prolonged dialysis or renal transplant.
Primary Clinical Effect
Cytotoxicity specific for kidneys, with delayed onset acute renal failure.
Treatment Overview
In general, treatment of Orellanine poisoning is based on assessment of severity of renal damage and consequent provision of appropriate renal support, up to and including haemodialysis and renal transplant in the most severe cases.

The latent period makes it unlikely patients will present early enough for decontamination to be of benefit. No antidote is available.
Cortinarius speciosissimus ( ) [ Original photo copyright © Irene Andersson ]
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