Drug-induced acute interstitial nephritis and vasculitis or vasculary rejection in renal allografts.
We describe a patient who sought treatment for acute renal allograft dysfunction 2 weeks after renal transplantation. Renal allograft biopsy (RAB) showed intimal arteritis, severe interstitial infiltration with a few eosinophils, and severe tubulitis. Pathologic diagnosis was acute rejection (grade 2b- Banff 93); however, another clinical diagnosis, drug-induced acute interstitial nephritis (AIN), was not excluded. Before the RAB, his trimethaprim-sulfamethoxazole (TMP-SMZ) treatment was discontinued. Renal function began to improve on biopsy day without antirejection therapy. Recovery of renal function without antirejection treatment and discontinuation of TMP-SMZ shows that renal pathology might be related to drug-induced dysfunction and drug-induced AIN and vasculitis. After 5 years, the patient and his renal allograft function are both well.
Sen
S
S
Department of Pathology, Section of Nephrology, Ege University, Medicine Faculty, Bornova, Izmir, Turkey. saitsen@med.ege.edu.tr
Bayrak
R
R
Ok
E
E
Başdemir
G
G
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D006084:Graft Rejection / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D014657:Vasculitis / Q000209:etiology*
D015662:Trimethoprim, Sulfamethoxazole Drug Combination