title: Renal papillary necrosis induced by naproxen.
abstract: 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.
authors.affiliation: Division of Pediatric Nephrology, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Kovacevic
authors.forename: Jay
authors.initials: J
authors.lastname: Bernstein
authors.forename: Rudolph P
authors.initials: RP
authors.lastname: Valentini
authors.forename: Abubakr
authors.initials: A
authors.lastname: Imam
authors.forename: Neena
authors.initials: N
authors.lastname: Gupta
authors.forename: Tej K
authors.initials: TK
authors.lastname: Mattoo
mesh_terms: 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
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009288:Naproxen