title: Indinavir-associated interstitial nephritis and urothelial inflammation: clinical and cytologic findings.
abstract: The objective of the present study was to characterize the genitourinary syndromes that accompany indinavir-associated pyuria. Of 23 indinavir-treated patients with persistent pyuria, 4 had isolated interstitial nephritis, 10 had both interstitial nephritis and urothelial inflammation, 7 had isolated urothelial inflammation, and 2 had pyuria with nonspecific urinary tract inflammation. A total of 21 patients had multinucleated histiocytes identified by cytologic testing of urine specimens. Urine abnormalities resolved in all 20 patients who stopped receiving indinavir therapy. Pyuria continued in the 3 patients who continued receiving indinavir. Six patients had elevated serum creatinine levels, which returned to baseline levels when indinavir was discontinued. In conclusion, indinavir-associated pyuria was frequently associated with evidence of interstitial nephritis and/or urothelial inflammation, multinucleated histiocytes were commonly present in urine specimens, and cessation of indinavir therapy was associated with prompt resolution of urine abnormalities.
authors.affiliation: Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, 20892, USA. jbkopp@nih.gov
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Kopp
authors.forename: Judith
authors.initials: J
authors.lastname: Falloon
authors.forename: Armando
authors.initials: A
authors.lastname: Filie
authors.forename: Andrea
authors.initials: A
authors.lastname: Abati
authors.forename: Christine
authors.initials: C
authors.lastname: King
authors.forename: Glen L
authors.initials: GL
authors.lastname: Hortin
authors.forename: JoAnn M
authors.initials: JM
authors.lastname: Mican
authors.forename: Ellen
authors.initials: E
authors.lastname: Vaughan
authors.forename: Kirk D
authors.initials: KD
authors.lastname: Miller
mesh_terms: D000328:Adult; D005260:Female; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D019469:Indinavir / Q000009:adverse effects*; D007249:Inflammation / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D011776:Pyuria / Q000139:chemically induced*; D019459:Urothelium / Q000187:drug effects / Q000473:pathology*
chemical_list: D017320:HIV Protease Inhibitors; D019469:Indinavir