Acute interstitial nephritis due to cefoperazone.
OBJECTIVE
To describe a case of cefoperazone-induced acute interstitial nephritis (AIN) in which the diagnosis was supported by renal biopsy.


METHODS
A 35-year-old woman presented to our hospital with decreased urine output and no past history of renal problems. Fifteen days prior to presentation, she had started treatment with intramuscular cefoperazone 1 g/day for a scalp infection. On day 12 of therapy, the patient noted decreased urine output, anorexia, and weakness, but she continued taking cefoperazone for 3 more days. Hemodialysis and oral prednisolone 1 mg/kg (30 mg twice daily) were started. Renal function returned to normal after 2 months of prednisolone treatment.


CONCLUSIONS
Although AIN has been linked with other cephalosporins, as of June 18, 2004, to our knowledge, this is the first report of a cefoperazone-induced case. We based our diagnosis on the features of acute-onset renal failure, abnormal urinalysis findings, eosinophilia, inflammatory infiltrate in the interstitium, and recovery from renal failure after initiation of corticosteroid treatment. Application of the Naranjo probability scale indicated a probable relationship between the acute renal failure secondary to the possible AIN and cefoperazone therapy in this patient.


CONCLUSIONS
This case indicates that cefoperazone, like other cephalosporins, can cause AIN. We recommend close monitoring of renal function in patients who are prescribed this drug.
Torun
Dilek
D
Faculty of Medicine, Baskent University, Adana Teaching and Medical Research Center, Adana, Turkey.
Sezer
Siren
S
Kayaselcuk
Fazilet
F
Zumrutdal
Aysegul
A
Ozdemir
Fatma N
FN
Haberal
Mehmet
M
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001806:Blood Urea Nitrogen; D002438:Cefoperazone / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D009846:Oliguria / Q000139:chemically induced; D011239:Prednisolone / Q000627:therapeutic use; D006435:Renal Dialysis
D000900:Anti-Bacterial Agents; D002438:Cefoperazone; D011239:Prednisolone; D003404:Creatinine