title: Ciprofloxacin-induced granulomatous interstitial nephritis and localized elastolysis.
abstract: Ciprofloxacin is known to cause acute interstitial nephritis. We report the first case of ciprofloxacin-induced granulomatous interstitial nephritis and localized elastolysis. The patient presented with acute renal failure and skin lesions following a 14-day course of ciprofloxacin administered for cellulitis. The patient had symmetric, palm-sized, tender violaceous plaques on both axillae. The renal biopsy revealed granulomatous interstitial disease. A skin biopsy revealed an elastolytic process with histocytic infiltration and calcification. After discontinuing ciprofloxacin and starting a short course of steroid therapy, the skin lesion and renal function improved promptly. The nephritis relapsed after prednisone was discontinued and responded to a second course of steroid therapy. Ciprofloxacin, like penicillin, can cause granulomatous interstitial nephritis and elastolysis. A prolonged course of steroid therapy may be indicated in patients with ciprofloxacin-induced granulomatous interstitial nephritis to avoid early relapse.
authors.affiliation: Department of Medicine, University of Arizona Health Sciences Center, Tucson 85724.
authors.forename: Y H
authors.initials: YH
authors.lastname: Lien
authors.forename: R
authors.initials: R
authors.lastname: Hansen
authors.forename: W F
authors.initials: WF
authors.lastname: Kern
authors.forename: J
authors.initials: J
authors.lastname: Bangert
authors.forename: R B
authors.initials: RB
authors.lastname: Nagle
authors.forename: M
authors.initials: M
authors.lastname: Ko
authors.forename: M S
authors.initials: MS
authors.lastname: Siskind
mesh_terms: D002939:Ciprofloxacin / Q000009:adverse effects*; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000150:complications / Q000473:pathology
chemical_list: D002939:Ciprofloxacin