Clozapine induced tubulointerstitial nephritis in a patient with paranoid schizophrenia.
We describe the development of tubulointerstitial nephritis after starting clozapine therapy in a patient with treatment-resistant schizophrenia. A 54-year-old mixed-race patient with a longstanding history of paranoid schizophrenia was started on the antipsychotic clozapine. Two months after starting clozapine he developed fevers, cough and acute renal failure which initially responded to 7 days of prednisolone but recurred after completing the steroid course. Renal biopsy confirmed acute tubulointerstitial nephritis and he was started on a course of steroids with renal recovery in 72 h. Clozapine was later stopped. This case highlights a serious and potential life-threatening complication of an important antipsychotic used in treatment-resistant schizophrenia.
Imperial College, London, UK.
Ravi
R
Parekh
Department of Rheumatology, UCLH, London, UK.
Zozik
Z
Fattah
Central Middlesex Hospital, London, UK.
Dilraj
D
Sahota
Department of Rheumatology, Central Middlesex Hospital, London, UK.
Bernie
B
Colaco
D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000473:pathology*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy*
D014150:Antipsychotic Agents; D003024:Clozapine