Carbamazepine-induced granulomatous necrotizing angiitis with acute renal failure.
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.
Imai
H
H
Third Department of Internal Medicine, Akita University School of Medicine, Japan.
Nakamoto
Y
Y
Hirokawa
M
M
Akihama
T
T
Miura
A B
AB
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
D002220:Carbamazepine