title: A patient with minimal change disease and acute focal tubulointerstitial nephritis due to traditional medicine: a case report and small literature review.
abstract: Gongjin-dan (GJD) is a traditional formula that is widely used in Korea and China, and it has been used from 1345 AD in China to improve the circulation between the kidneys and the heart and to prevent all diseases. However, its adverse effects have not yet been reported. We present a patient with minimal change disease and focal tubulointerstitial nephritis associated with GJD. A 72-year-old man visited the clinic for generalized edema 20 days after starting GJD. His serum albumin level was low and nephrotic-range proteinuria was detected. A kidney biopsy showed minimal change disease and acute tubulointerstitial nephritis. After stopping GJD, a spontaneous complete remission was achieved. We discuss the possible pathogenesis of GJD-induced minimal change disease and review the adverse effects of GJD's ingredients and traditional Chinese medicines that can induce proteinuria. We report a new adverse effect of GJD, which might induce increased IL-13 production and an allergic response, leading to minimal change disease and focal tubulointerstitial nephritis.
authors.affiliation: Graduate School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea; Hemin Traditional Korean Medical Clinic, Busan, Republic of Korea.
authors.forename: Keun-Hyeun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Division of Applied Medicine, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea. Electronic address: jhsol33@pusan.ac.kr.
authors.forename: Han-Sol
authors.initials: HS
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
mesh_terms: D000368:Aged; D000485:Allergens; D000818:Animals; D003670:Deer; D005229:Fatty Acids, Monounsaturated; D006801:Humans; D018793:Interleukin-13 / Q000378:metabolism; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008516:Medicine, Chinese Traditional; D009395:Nephritis, Interstitial / Q000209:etiology*; D009402:Nephrosis, Lipoid / Q000209:etiology*; D010936:Plant Extracts / Q000009:adverse effects*; D011507:Proteinuria / Q000209:etiology
chemical_list: D000485:Allergens; D005229:Fatty Acids, Monounsaturated; C546310:Gongjin-dan; D018793:Interleukin-13; D010936:Plant Extracts; C008563:musk
keywords: Acute interstitial nephritis; TCM; adverse effect; minimal change nephrotic syndrome; nephrotoxin; toxin