Cephotaxime-associated allergic interstitial nephritis and MPO-ANCA positive vasculitis.
We report a case of reversible acute renal failure after cefotaxime treatment in a patient affected by non-Hodgkin lymphoma. Renal biopsy showed necrotizing vasculitis associated with eosinophil-rich interstitial inflammatory infiltrates and patchy infiltrates of CD20+ lymphoid cells. High serum p-ANCA titers were also detected. Drug withdrawal was closely related with recovery of renal function and disappearance of ANCA. Acute renal failure therefore represented a consequence of ANCA-mediated renal vasculitis and acute interstitial nephritis related to cefotaxime treatment.
Feriozzi
S
S
Nefrologia e Dialisi, Ospedale Belcolle, Viterbo, Italy. ancarani@isa.it
Muda
A O
AO
Gomes
V
V
Montanaro
M
M
Faraggiana
T
T
Ancarani
E
E
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002511:Cephalosporins / Q000009:adverse effects*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000188:drug therapy; D008297:Male; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D009195:Peroxidase / Q000276:immunology*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers; D002511:Cephalosporins; D009195:Peroxidase