[Chronic inflammatory intestinal disease and nephritis].
An 11 year old CD-patient developed an interstitial nephritis and acute kidney failure following treatment with Mesalazine (5-ASA) and Salazosulfapyridine (SASP). After removal of the medication and treatment with hemofiltration and prednisone there was only an incomplete recovery of the renal function (creatinine-clearance 34 ml/1,73 m2/min). It is thought that an hyperergic-allergic reaction due to SASP and 5-ASA causes interstitial nephritis in inflammatory bowel disease (IBD). This reaction can be induced by re-exposition too. On the other hand IBD can be associated with glomerulonephritis. This could be a not very well known extraintestinal manifestation in IBD caused by immune-complexes in serum and glomerula. A rapid histological verification of the renal disease is necessary for successful treatment. In both renal manifestations chronic courses are possible. These observations should not lead to avoid SASP/5-ASA in treatment of IBD, but renal function should be routinely investigated.
Abteilung der Klinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg.
R
R
Behrens
H
H
Ruder
D058186:Acute Kidney Injury / Q000209:etiology*; D000636:Aminosalicylic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000150:complications; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D019804:Mesalamine; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000209:etiology*; D012460:Sulfasalazine / Q000008:administration & dosage / Q000009:adverse effects*
D000636:Aminosalicylic Acids; D012460:Sulfasalazine; D019804:Mesalamine
Chronisch-entzündliche Darmerkrankung und Nephritis.