Renal papillary necrosis induced by naproxen.
A 17-year-old healthy girl was admitted to our hospital with diffuse abdominal pain and decreased oral intake of about 11 days duration. About a week prior to admission, she had taken naproxen, 250 mg four times a day for 4 days. Physical examination was normal except for diffuse abdominal tenderness on deep palpation. Investigations revealed high serum BUN (42 mg/dl) and creatinine (4.0 mg/dl). Serum electrolytes and complement (C3, C4) levels and urinalysis were normal. Antinuclear-antibody and anti-dsDNA were negative. Kidney biopsy revealed renal papillary necrosis, acute tubular necrosis, and focal interstitial nephritis. A diagnosis of nonoliguric acute renal failure due to naproxen nephrotoxicity was made. She received intravenous hydration, and oral steroids, which was gradually discontinued in 3 months. A follow-up at 4 months revealed normal renal function with a serum creatinine of 1.1 mg/dl, BUN 7 mg/dl, and normal urinalysis. The report highlights a need for caution while using naproxen or any other nonsteroidal anti-inflammatory drugs, even for a short duration.
Kovacevic
Larisa
L
Division of Pediatric Nephrology, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, USA.
Bernstein
Jay
J
Valentini
Rudolph P
RP
Imam
Abubakr
A
Gupta
Neena
N
Mattoo
Tej K
TK
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007679:Kidney Medulla / Q000473:pathology*; D009288:Naproxen / Q000009:adverse effects*; D009336:Necrosis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009288:Naproxen