Granulomatous Interstitial Nephritis after Nonsteroidal Anti-Inflammatory Drugs

Schwarz, Anke; Krause, Peter H.; Keller, Frieder; Offermann, G.; Mihatsch, Michael J.

doi:10.1159/000167627

Cited by 47 publications

(24 citation statements)

References 18 publications

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“…The pathophysiology of drug hypersensitivity causing granulomatous interstitial nephritis is poorly understood [12][13][14][15]. However, careful analysis of this short series suggests that this complication of omeprazole treatment might be more liable to affect persons with a particular immunologic background.…”

Section: Discussionmentioning

confidence: 92%

Immunoallergic Granulomatous Interstitial Nephritis following Treatment with Omeprazole

Montseny

Meyrier

1998

Am J Nephrol

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A 69-year-old male who had a long history of ocular myasthenia was treated with omeprazole for 3 months. Progressive renal insufficiency was discovered fortuitously. There were no clinical or laboratory manifestations of immunoallergy. Renal biopsy revealed severe granulomatous interstitial nephritis, tubular injury and fibrosis. Histology of a liver nodule disclosed hepatic granulomatous involvement. Withdrawal of omeprazole and a short course of corticosteroids were followed by improvement but not normalization of renal function. This is the eighth report of omeprazole-induced interstitial nephritis. In the present case as in 2 others in the literature, the patients had been followed up for an autoimmune disease previously, which suggests that in patients with such a background, patients should be examined regularly for renal functional impairment during treatment with omeprazole.

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Section: Discussionmentioning

confidence: 92%

Immunoallergic Granulomatous Interstitial Nephritis following Treatment with Omeprazole

Montseny

Meyrier

1998

Am J Nephrol

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“…In a few cases, a renal biopsy documented a severe interstitial nephritis, but granulomas were never described. 12,13 The incidence of interstitial nephritis is at its maximum during the first year of treatment and the withdrawal of 5-ASA is followed by an increase in renal function. In the cases where there is no improvement of renal function following the withdrawal of the drug, a cycle of treatment with high doses of steroids can be useful.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous Interstitial Nephritis in a Patient with Crohn’s Disease

et al. 2012

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A case of granulomatous interstitial nephritis (GIN) associated with Crohn's disease (CD) was reported. GIN is a rare pathological finding in renal biopsy specimens. In a patient affected by CD, granulomas may be found in various tissues and organs such as lymph nodes, mesentery, liver, and lungs and occasionally in bones, joints, and skeletal muscle. Few cases of granuloma have been reported in the kidney, and it is not always possible to relate the presence of granuloma to CD, to other interstitial granulomatosis diseases, or to a drug-induced reaction. The issue has a remarkable clinical effect; indeed, the answer requires a completely different therapeutic approach. The diagnosis analysis on the basis of clinicalpathological evidences and on reports from literature is discussed.

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“…Infection as a cause of AIN in this case is unlikely, as no clinical or laboratory data showed any indication of infection. Other medications the child was taking were penicillin and diclofenac, both known to be associated with AIN [4,6,15,17]. Prophylactic penicillin had been taken for 3 years with no adverse eects.…”

Section: Discussionmentioning

confidence: 99%