Chronic tubulointerstitial nephritis induced by 5-aminosalicylate in an ulcerative colitis patient: a rare but serious adverse event.
The 5-aminosalicylate is widely prescribed in inflammatory bowel disease patients. Its potential for renal damage has been seldom described. We report a case of a 23-year-old man who started 5-aminosalicylate after being diagnosed with ulcerative colitis. One year after, a significant decline on his creatinine clearance was noted, however, at that time, he was on an acute flare of his bowel disease and the 5-aminosalicylate dose was increased. Six months later, his renal function kept worsening and, on drug-induced toxicity suspicion, 5-aminosalicylate was halted and a kidney biopsy demonstrated a chronic tubulointerstitial nephritis. Steroids and azathioprine were started leading to partial recovery and stabilisation of his renal function. Physicians who prescribe 5-aminosalicylate to patients with inflammatory bowel disease should be aware of this adverse event.
Department of Gastroenterology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Pedro
P
Magalhães-Costa
Department of Gastroenterology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Leopoldo
L
Matos
Department of Gastroenterology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Cristina
C
Chagas
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000009:adverse effects*; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000473:pathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine