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nsaid and acute tubulointerstitial nephritis

María Camila Aguilar, Marcela Lonngi, Alejandra de-la-Torre
PURPOSE: To review the literature on tubulointerstitial nephritis and uveitis (TINU) syndrome, and to report a case of a patient with relapsing polychondritis (RP) and TINU syndrome. METHOD: TINU syndrome is a rare oculorenal inflammatory disorder. It is more common in young women with autoimmune conditions, infections, systemic disease, and previous use of medications. We report the case of a 62-year-old woman with relapsing polychondritis and a 2-year history of acute, recurrent, asymmetric, bilateral, anterior, non-granulomatous uveitis accompanied by tubulointerstitial nephritis...
August 2016: Ocular Immunology and Inflammation
Montserrat Garcia, Ramón Saracho, Nekane Jaio, Kalliopi Vrotsoukanari, Carmelo Aguirre
Drugs are a frequent cause of acute tubulointerstitial nephritis (ATIN). Antibiotics, non-steroidal anti-inflammatory drugs and recently proton pump inhibitors stand among the most commonly responsible ones. However, their respective responsibility is not well known. This study reports 33 cases of drug-induced ATIN (DI-ATIN), the most frequent ones being metamizole and omeprazole. Clinicians often fail to diagnose DI-ATIN because its signs and symptoms are non-specific and differ from the now classic form observed with methicillin...
December 2010: NDT Plus
Olga Balafa, Georgios Liapis, Anila Duni, Sophia Xiromeriti, Rigas Kalaitzidis, Moses Elisaf
We present a case which emphasizes the importance of performing a kidney biopsy in each case of acute kidney injury (AKI) of unknown etiology. The unexpected histological diagnosis of granulomatous interstitial nephritis (GIN) is a rare cause of AKI. The main causes of GIN include drugs (NSAIDs, antibiotics), sarcoidosis, and infections (mycobacterial and fungal). In our case, a 68-year-old woman was admitted with AKI, absence of symptoms and unremarkable history, apart from coronary heart disease. Renal biopsy was performed, since history as well as clinical and laboratory data could not define a cause of AKI...
October 2015: Clinical Nephrology
A Valluri, L Hetherington, E Mcquarrie, S Fleming, D Kipgen, C C Geddes, B Mackinnon, S Bell
BACKGROUND AND AIMS: Acute tubulointerstitial nephritis (ATIN) is a potentially reversible cause of acute kidney injury with the majority of cases drug related. Our aims were to examine the incidence profile of patients with ATIN in Scotland and to assess the impact of corticosteroid treatment. DESIGN AND METHODS: All adult patients with biopsy-proven ATIN, diagnosed between 2000 and 2012, presenting to renal units serving 1.9 of Scotland's 5 million population were included...
July 2015: QJM: Monthly Journal of the Association of Physicians
Ya-Li Cao, Zhi-Gang Tian, Fang Wang, Wen-Ge Li, Dan-Ying Cheng, Yan-Fang Yang, Hong-Mei Gao
AIM: To determine the clinicopathological characteristics of nonsteroidal anti-inflammatory drug (NSAID)-induced acute hepato-nephrotoxicity among Chinese patients. METHODS: We conducted a retrospective chart review of patients using the International Classification of Diseases, Ninth Revision diagnosis code for acute kidney injury (AKI) (584.5 or 584.9) and for acute liver injury (ALI) (570.0 or 573.3) from January 2004 to December 2013. Medical records were reviewed to confirm the diagnosis of AKI and ALI and to quantify NSAID administration...
October 14, 2014: World Journal of Gastroenterology: WJG
Maria Dolores Redondo-Pachon, Ricardo Enriquez, Ana Esther Sirvent, Isabel Millan, Alberto Romero, Francisco Amorós
Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diagnosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis...
January 2014: Saudi Journal of Kidney Diseases and Transplantation
Monica Gupta, Sanjay D Cruz, Ritambhara Nada, Purnima Aggarwal
We describe a case of a 40-year-old lady diabetic and hypertensive, who presented with increasing fatigue and decreased physical endurance attributable to deterioration in renal function. The renal biopsy revealed drug-induced acute tubulointerstitial nephritis and the chronology of the events suggested the aetiology to be a recent intake of aceclofenac for knee pain. The patient improved with oral corticosteroids and the renal functions returned to baseline in 3 weeks. We did not come across a case of aceclofenac-induced acute tubulointerstitial nephritis on extensive electronic search of literature...
2013: BMJ Case Reports
H Nandakoban, T J Furlong, J R Flack
BACKGROUND: Acute tubulointerstitial nephritis, a cause of acute kidney injury, is seen occasionally following treatment with medications such as antibiotics and non-steroidal anti-inflammatory drugs. To date, the development of biopsy-proven acute tubulointerstitial nephritis after treatment with exenatide has not been reported. CASE REPORT: A 58-year-old man was prescribed exenatide for poorly controlled Type 2 diabetes mellitus. He subsequently developed deterioration in kidney function, with the estimated glomerular filtration rate declining from 59 to 39 ml min(-1) 1...
January 2013: Diabetic Medicine: a Journal of the British Diabetic Association
Amal Abdel Ghani, Salah Al Waheeb, Ekhlas Al Homoud
A 37-year-old lady presented with hypercalcemia and acute renal impairment. She had no previous medical problems apart from the use of non steroidal anti-inflammatory drugs for nonspecific body pains. Her abdominal ultrasound scan as well as urine studies were nonspecific. Further workup for hypercalcemia (skeletal survey, high resolution computed tomography (CT) of the chest and abdomen, purified protein derivative (PPD) test, serum protein electrophoresis, tumor markers, immunology screening, and Bence Jones proteinuria) was negative...
November 2011: Saudi Journal of Kidney Diseases and Transplantation
Tim Ulinski, Anne-Laure Sellier-Leclerc, Elena Tudorache, Albert Bensman, Bilal Aoun
Acute tubulointerstitial nephritis (TIN) is a frequent cause of acute renal failure, characterised by the presence of inflammatory cell infiltrate in the interstitium of the kidney. Immuno-allergic reaction to certain medications, mainly non-steroidal anti-inflammatory drugs and antibiotics are by far the most important etiology for TIN today, but other situations such as infections, toxins, and vasculitis are known to induce TIN. Incidence of TIN is increasing, probably due to prescription habits and NSAID overuse, representing 3-7% of acute kidney injury in biopsies in children...
July 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
J W Rey, O Schreiner, A P Barreiros, M Heise, M Krupp, M Schuchmann, G Otto, P R Galle, A Teufel
INTRODUCTION: Drug-induced tubulointerstitial nephritis and acute tubular necrosis are common, and are often caused by drugs especially antibiotics or non-steroidal anti-inflammatory drugs. Drug-induced liver dysfunction and renal failure after subcutaneous injection of phosphatidylcholine was not reported so far. 3-sn-Phosphatidylcholine has been described as a cell lysis reaction-inducing drug. Its in vitro data indicated a relevant toxicity potential. In particular human cell types such as fibroblast-like preadipocytes, vascular and skeletal muscle cells, or renal epithelial cells react more sensitive than other human cell types...
March 2011: Zeitschrift Für Gastroenterologie
Tetsuhiro Tanaka, Masaomi Nangaku
Injury to the interstitium of the kidney is regarded as a common pathway leading to end-stage renal insufficiency, regardless of etiology. Tubular interstitial nephritis is characterized histologically by inflammatory changes in the tubulointerstitial compartment, such as interstitial edema, leukocyte infiltration, accumulation of extracellular matrix proteins, tubular dilation and atrophy. Acute interstitial nephritis is often associated with use of drugs, such as β-lactam antibiotics and non-steroidal anti-inflammatory drugs, and is likely mediated through allergic mechanisms...
2011: Contributions to Nephrology
R John, A M Herzenberg
A number of therapeutic agents can adversely affect the kidney, resulting in tubulointerstitial, glomerular or vascular disease. Drug-induced tubulointerstitial nephritis and acute tubular necrosis are common, and are often cause by antibiotics or non-steroidal anti-inflammatory drugs. Drug-induced glomerular and vascular disease is relatively rare. This review describes the morphological patterns of drug-induced disease in the kidney. The histopathological changes are often similar to disease that is idiopathic or due to other causes, so that awareness and clinical correlation are most helpful to arrive at the aetiology...
June 2009: Journal of Clinical Pathology
Jeffery T Fletcher, Nicole Graf, Anthony Scarman, Hamda Saleh, Stephen I Alexander
The nephrotoxic potential of anti-inflammatory drugs alone and in compound preparations has been known for over fifty years. Nephrotoxicity associated with selective cyclooxygenase 2 (COX-2) inhibitor use is reported in adult patients but not in children. We present here the first report of reversible acute renal failure associated with the COX-2 inhibitor rofecoxib (Vioxx) in three children. Patient 1, an 18 month old girl with neonatal Bartter syndrome, developed acute renal failure with a peak creatinine of 1...
December 2006: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
M Ortiz, C Mon, M J Fernández, R Sánchez, F Mampaso, F Alvarez Ude
The nephrotoxic effect of nonselective nonsteroidal anti-inflamatory drugs (NSAIDS) has been widely described. The main benefit of the Cox-2 inhibitors in relation to the NSAIDS is the production of a very similar analgesic effect, but with fewer gastrointestinal side effects. However, their effects on renal function are little known as yet and their long-term safety is still pending definition. The use of selective Cox-2 inhibitors as anti-inflamatory analgesic is becoming more and more common in our environment...
2005: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Iwao Ohno
This review summarizes drug induced nephrotic syndrome. Major drugs which induce drug related nephrotoxicity are antibiotics, NSAID, radiocontrast media, anticancer drug and antirheumatic drug. Drug induced nephropathy can show various forms of renal diseases. The nephropathy consists of acute tubular necrosis, acute tubulointerstitial nephritis, pre-renal type renal failure, obstructive renal failure, chronic tubulointerstitial nephritis and glomerular damage. Major drugs which induce nephrotic syndrome and glomerular damage are gold, penicillamine, bucillamine and NSAID...
October 2004: Nihon Rinsho. Japanese Journal of Clinical Medicine
U Ravnskov
AIMS: To study the mechanisms behind NSAID-associated nephropathy. METHODS: Analysis of published case reports satisfying strict criteria for NSAID nephropathy. RESULTS: Ninety-seven cases with acute nephritis (AN; 19 patients), minimal change nephropathy (MC; 38 patients), membranous glomerulonephritis (MGN; 19 patients), focal sclerosis (FS; 13 patients) and other glomerulonephritis subgroups (8 patients) were identified. Hypersensitivity reactions were seen in all groups, most often in AN...
February 1999: British Journal of Clinical Pharmacology
S F Wen
While the relative incidence of serious nephrotoxicities in the population consuming nonsteroidal anti-inflammatory drugs (NSAIDs) is very low, the frequency of adverse events in patients at risk has considerably increased due to the rising popularity of the use of the drugs in recent years. Under normal conditions, NSAIDs have relatively little effect on the kidney because of low renal production of prostaglandins. However, in the presence of renal hypoperfusion in which local synthesis of vasodilator prostaglandins is increased to protect the glomerular hemodynamics and to maintain appropriate renal tubular transport of fluid and electrolytes, inhibition of prostaglandin synthesis by NSAIDs can lead to vasoconstrictive acute renal failure as well as fluid and electrolyte disorders such as sodium retention and resistance to diuretics, hyponatremia and hyperkalemia...
March 1997: Journal of the Formosan Medical Association, Taiwan Yi Zhi
G L Bakris, S R Kern
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common cause of acute renal failure. The clinical presentation differs from that of interstitial nephritis due to antibiotic use: proteinuria is much more common in NSAID-induced nephritis, while eosinophilia, eosinophiluria, fever and rash are more common in antibiotic-related nephritis. Tubulointerstitial disease associated with NSAID use is more common in women than in men and is more frequently seen in the elderly. Because no prospective study of treatment for NSAID-induced acute tubulointerstitial nephritis has been performed, the efficacy of steroid therapy remains uncertain...
October 1989: American Family Physician
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