title: Cefpodoxime proxetil-related hemolysis and acute interstitial nephritis.
abstract: OBJECTIVE
  We report a case of acute interstitial nephritis (AIN) and immune hemolytic anemia (IHA) associated with cefpodoxime therapy.
  
  
  METHODS
  A patient with a recent history of cefpodoxime proxetil treatment presented with elevated serum creatinine, oliguria, nausea, vomiting, and dyspnea. Evidence of renal failure, abnormal urinalysis, and renal biopsy with inflammatory infiltrate in the interstitium confirmed a diagnosis of AIN. The patient subsequently developed IHA, which was confirmed by peripheral blood smear results and positive Coombs' test. The patient recovered after dialysis therapy and 2 days of intravenous methylprednisolone (500mg/day) followed by oral prednisolone (60 mg/day), which was rapidly tapered and stopped within 3 weeks.
  
  
  CONCLUSIONS
  To our knowledge, cefpodoxime-induced AIN and IHA are unprecedented. Physicians should be aware that drug-induced AIN and hemolysis can be associated with cefpodoxime proxetil.
authors.affiliation: Fatih University Medical School Department of Nephrology, Ankara, Turkey. drhakkiyilmaz@yahoo.com
authors.forename: Hakki
authors.initials: H
authors.lastname: Yilmaz
authors.forename: Mukadder Ayse
authors.initials: MA
authors.lastname: Bilgiç
authors.forename: Nuket
authors.initials: N
authors.lastname: Bavbek
authors.forename: Ali
authors.initials: A
authors.lastname: Akçay
mesh_terms: D000208:Acute Disease; D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015296:Ceftizoxime / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D006435:Renal Dialysis / Q000379:methods; D000097627:Cefpodoxime Proxetil
chemical_list: D000900:Anti-Bacterial Agents; D015296:Ceftizoxime; D005938:Glucocorticoids; D008775:Methylprednisolone; D011239:Prednisolone; D000097627:Cefpodoxime Proxetil