title: Carbamazepine-induced granulomatous necrotizing angiitis with acute renal failure.
abstract: A 42-year-old male treated with carbamazepine developed a skin eruption in the trunk, followed by acute renal failure. Laboratory data revealed leukocytosis (15,700/mm3) with eosinophilia (37%). A renal biopsy disclosed granulomatous necrotizing angiitis that differed from classic periateritis nodosa and hypersensitivity angiitis. All drugs were discontinued immediately, and there was a gradual improvement of the renal function. A carefully performed provocation test using carbamazepine was positive. We made a diagnosis of carbamazepine-induced granulomatous necrotizing angiitis. Only 6 cases of drug-induced granulomatous angiitis have been reported prior to the present case. Drug-induced granulomatous angiitis is often fatal. The present report suggests the importance of making a diagnosis quickly, and providing adequate treatment in order to prevent a fatal course.
authors.affiliation: Third Department of Internal Medicine, Akita University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Imai
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: M
authors.initials: M
authors.lastname: Hirokawa
authors.forename: T
authors.initials: T
authors.lastname: Akihama
authors.forename: A B
authors.initials: AB
authors.lastname: Miura
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000328:Adult; D002220:Carbamazepine / Q000009:adverse effects*; D015267:Churg-Strauss Syndrome / Q000139:chemically induced* / Q000473:pathology; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male
chemical_list: D002220:Carbamazepine