title: Biopsy-proven vancomycin-associated interstitial nephritis and acute tubular necrosis.
abstract: Fewer than ten biopsy-proven case reports exist on vancomycin-associated interstitial nephritis (VAIN) and vancomycin-associated acute tubular necrosis (VAATN). Among these, several are confounded by the use of other potentially offending drugs. We report a case of isolated VAIN/VAATN in a patient on no other potentially nephrotoxic agents other than vancomycin. The patient received intravenous vancomycin for coagulase-negative staphylococcus bacteremia. Her baseline serum creatinine of 0.9 mg/dL increased to 9.6 mg/dL after 1 week of therapy during which vancomycin levels peaked at 141 μg/mL. Renal biopsy revealed acute interstitial nephritis with lymphocytic and eosinophilic infiltrate and acute tubular necrosis. Upon discontinuation of vancomycin and administration of prednisone complete renal recovery ensued over a period of 4 weeks.
authors.affiliation: Lankenau Medical Center, 100 E Lancaster Ave, Lankenau Medical Office Building West, Suite 130, Wynnewood, PA 19096, USA. nhtike@aol.com
authors.forename: Naing Lin
authors.initials: NL
authors.lastname: Htike
authors.forename: Jerome
authors.initials: J
authors.lastname: Santoro
authors.forename: Brett
authors.initials: B
authors.lastname: Gilbert
authors.forename: I Bruce
authors.initials: IB
authors.lastname: Elfenbein
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Teehan
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001706:Biopsy; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000473:pathology; D011241:Prednisone; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D011241:Prednisone
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