In five well-documented cases, three patients suffered renal failure. One of the patients also lost liver function. There are about 40 species rather similar to Amanita smithiana in the section Lepidella of the genus Amanita. All should be considered poisonous. The toxins are unknown.
Poisoning looks like orellanine symptoms except for the much more rapid onset.
Symptoms begin between 4 and 11 hours post ingestion and include vomiting, abdominal pain and diarrhea followed much later by reduced ability or inability to urinate.