title: Acute interstitial nephritis due to deferasirox: a case report.
abstract: Deferasirox is a new oral iron chelator used to treat transfusional iron overload. Pre-marketing clinical trials revealed little organ-specific toxicity. Increases in serum creatinine were noted in one-third of patients but were mild and non-progressive. We describe a 62-year-old man with myelodysplastic syndrome who developed a progressive decline in renal function after starting deferasirox. A kidney biopsy showed acute interstitial nephritis with increased eosinophils, suggesting drug hypersensitivity. Deferasirox was discontinued and renal function returned to baseline. This is the first pathological description of deferasirox-related acute kidney injury in humans, which differs from tubular vacuolization observed in animals.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W Markham, Slot 501, Little Rock, AR 72205, USA. gbrosnahan@uams.edu
authors.forename: Godela
authors.initials: G
authors.lastname: Brosnahan
authors.forename: Neriman
authors.initials: N
authors.lastname: Gokden
authors.forename: Sundararaman
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000208:Acute Disease; D001565:Benzoates / Q000009:adverse effects*; D000077588:Deferasirox; D004342:Drug Hypersensitivity / Q000473:pathology; D004804:Eosinophils / Q000473:pathology; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects*; D019190:Iron Overload / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000473:pathology; D014230:Triazoles / Q000009:adverse effects*
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox