Successful steroid therapy for cefdinir-induced acute tubulointerstitial nephritis with progressive renal failure.
A 58-year-old woman was admitted to our hospital because of renal dysfunction that continued to progress even after withdrawal of cefdinir, the presumed cause of acute renal failure. Renal histologic findings included interstitial fibrosis accompanied by moderate lymphocytic infiltration, and tubular atrophy with reduced numbers of epithelial cells. Mesangial cells and glomerular basement membranes were nearly normal. Scintigraphy with 67gallium disclosed diffuse abnormal accumulation in both kidneys. A lymphocyte stimulation test with cefdinir was positive. The patient was diagnosed with acute tubulointerstitial nephritis caused by cefdinir. Serum creatinine concentrations continued to rise after withdrawal of the drug, but steroid therapy was effective in normalizing renal function.
Kimura
Y
Y
Second Department of Internal Medicine, Iwate Medical University, Morioka.
Kawamura
M
M
Owada
M
M
Fujiwara
T
T
Maesawa
C
C
Hiramori
K
K
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001706:Biopsy; D001991:Bronchitis / Q000188:drug therapy; D002097:C-Reactive Protein / Q000032:analysis; D000077525:Cefdinir; D002511:Cephalosporins / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007677:Kidney Function Tests; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D015242:Ofloxacin / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use*; D011877:Radionuclide Imaging
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D002511:Cephalosporins; D006635:Histamine H2 Antagonists; D015738:Famotidine; D002097:C-Reactive Protein; D011239:Prednisolone; D015242:Ofloxacin; D003404:Creatinine; D000077525:Cefdinir; D008775:Methylprednisolone