Ciprofloxacin-induced granulomatous interstitial nephritis and localized elastolysis.
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.
Lien
Y H
YH
Department of Medicine, University of Arizona Health Sciences Center, Tucson 85724.
Hansen
R
R
Kern
W F
WF
Bangert
J
J
Nagle
R B
RB
Ko
M
M
Siskind
M S
MS
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
D002939:Ciprofloxacin