Reactions 1704, p62 - 2 Jun 2018 Acute interstitial nephritis: case report A 21-year-old woman developed acute interstitial nephritis (AIN) during treatment with ceftriaxone and azithromycin for atypical pneumonia [dosages and routes not stated]. The woman, who was hospitalised for the treatment of atypical pneumonia, started on a 9-day antibiotic therapy with azithromycin and ceftriaxone. On admission, her creatinine level was 0.9 mg/dL. On the fourth day of therapy, she developed acute kidney injury (AKI) with increase in creatinine level from 0.98 mg/dL to 4.36 mg/dL. Her creatinine level continued to increase and reached to 11.6 mg/dL on the completion of antibiotic therapy (day 9). On day 12, her creatinine level was 16.2 mg/dL and she was started on haemodialysis. An initial diagnosis of acute tubular necrosis in the setting of sepsis was made. She did not show rash, pyuria, eosinophilia or eosinophiluria, which were suggestive of AIN. Renal biopsy findings showed diffuse interstitial inflammation and eosinophils in the inset. The biopsy findings were consistent with drug-induced AIN. On day 14, her creatinine level was dropped to 7 mg/dL and the haemodialysis was stopped. The woman was started on steriod therapy. On day 18, she was discharged, with a creatinine level of 5.9 mg/dL. She showed complete recovery of her renal function in six weeks, with creatinine level of 0.7 mg/dL. Author comment: "[R]enal biopsy was consistent with drug-induced AIN." "AIN typically develops 7–10 days after drug exposure and presents with variable clinical features." "Drug-induced acute interstitial nephritis is an important cause of unexplained acute kidney injury in hospitalized patients." Chamarthi G, et al. Acute interstitial nephritis: a multifaceted disease. Clinical Case Reports 6: 946-947, No. 5, May 2018. Available from: URL: http:// doi.org/10.1002/ccr3.1456 - USA 803322807 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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