Korean J Med.  1998 Feb;54(2):261-265.

A Case of Drug-Induced Acute Interstitial Nephritis Accompanying Prominent Neutrophil Infiltration

• Shin TR
• Kim MS
• Hong ES
• Lee EY
• Kang DH
• Choi GB
• Yoon KI
• Sung SH

Abstract

Drug-induced acute interstitial nephritis, induced by unknown immunologic mechanisms, is inflammatory lesions of the tubulointerstitial area due to several kinds of drugs as hapten and a rare, but increasingly recognized cause of acute renal failure. Drugs implicated include not only methicillin and other penicillins but also diuretics and nonsteroidal anti-imflammatory agents. Diagnosis of acute interstitial nephritis is important, because withdrawal of the offending agent will usually result in rapid improvement in renal function, and steroid therapy may reduce residual chronic renal damage. We are reporting a case of diuretic-induced acute interstitial nephritis in a 49 year-old female patient, who was given hydrochlorothiazide to treat hypertension. A percutaneous biopsy showed tubulointerstitial nephritis accopanying prominent neutrophil infiltration without glomerulitis. Withdrawal of the drug and use of corticosteroid led to remarkable improvement with renal function returning to normal.

Keyword

interstitial nephritis; drug-induced; thiazide diuretic

MeSH Terms

Acute Kidney Injury
Biopsy
Diagnosis
Diuretics
Female
Humans
Hydrochlorothiazide
Hypertension
Methicillin
Middle Aged
Nephritis, Interstitial*
Neutrophil Infiltration*
Neutrophils*
Penicillins
Diuretics
Hydrochlorothiazide
Methicillin
Penicillins