title: Triamterene crystalline nephropathy.
abstract: Medications can cause a tubulointerstitial insult leading to acute kidney injury through multiple mechanisms. Acute tubular injury, a dose-dependent process, occurs due to direct toxicity on tubular cells. Acute interstitial nephritis characterized by interstitial inflammation and tubulitis develops from drugs that incite an allergic reaction. Other less common mechanisms include osmotic nephrosis and crystalline nephropathy. The latter complication is rare but has been associated with several drugs, such as sulfadiazine, indinavir, methotrexate, and ciprofloxacin. Triamterene crystalline nephropathy has been reported only rarely, and its histologic characteristics are not well characterized. We report 2 cases of triamterene crystalline nephropathy, one of which initially was misdiagnosed as 2,8-dihydroxyadenine crystalline nephropathy.
authors: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. Electronic address: nasr.samih@mayo.edu.
authors: Samih H
authors: SH
authors: Nasr
authors: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
authors: Dawn S
authors: DS
authors: Milliner
authors: Oxford Nephrology and Hypertension Associates and North Mississippi Medical Center, Tupelo, MS.
authors: Thomas D
authors: TD
authors: Wooldridge
authors: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors: Sanjeev
authors: S
authors: Sethi
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001706:Biopsy; D003404:Creatinine / Q000097:blood; D003951:Diagnostic Errors / Q000517:prevention & control; D004338:Drug Combinations; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005455:Fluorescent Antibody Technique; D005919:Glomerular Filtration Rate; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000009:adverse effects*; D007668:Kidney / Q000473:pathology*; D056929:Liddle Syndrome / Q000188:drug therapy; D008575:Meniere Disease / Q000188:drug therapy; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D014223:Triamterene / Q000008:administration & dosage / Q000009:adverse effects*; D028761:Withholding Treatment
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D006852:Hydrochlorothiazide; C020743:hydrochlorothiazide-triamterene; D003404:Creatinine; D014223:Triamterene
keywords: Triamterene; acute kidney injury; crystalline nephropathy; drug nephrotoxicity; kidney biopsy