title: Acute kidney injury in a preterm infant homozygous for the C3435T polymorphism in the ABCB1 gene given oral morphine.
abstract: A 34-week infant born from a mother with a history of drug abuse developed neonatal abstinence syndrome (NAS) in the first hours of life. Urine drug screening was positive for cocaine and heroin. The infant developed acute kidney injury and bilateral hydronephrosis while receiving oral morphine for control of NAS. Cessation of morphine therapy and urinary catheterization resulted in a rapid and complete resolution of the symptoms. Our patient was homozygous for the C3435T polymorphism in the ABCB1 gene, a polymorphism previously associated with impaired P-glycoprotein activity. We hypothesize that acute renal toxicity was related to accumulation of morphine within urothelial cells due to genetically determined impaired P-glycoprotein activity.
authors.affiliation: Department of Pediatrics , L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pogliani
authors.affiliation: Department of Pediatrics , L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mameli
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences , Consiglio Nazionale delle Ricerche Institute of Neuroscience, L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Cattaneo
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences , Consiglio Nazionale delle Ricerche Institute of Neuroscience, L. Sacco Hospital, University of Milan , Milan , Italy ; E. Medea Scientific Institute , Bosisio Parini , Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Clementi
authors.affiliation: Department of Pediatrics , L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Meneghin
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences , Consiglio Nazionale delle Ricerche Institute of Neuroscience, L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Radice
authors.affiliation: Castelli Clinic , Bergamo , Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Bruno
authors.affiliation: Department of Pediatrics , L. Sacco Hospital, University of Milan , Milan , Italy.
authors.forename: Gian Vincenzo
authors.initials: GV
authors.lastname: Zuccotti
keywords: acute kidney injury; morphine; pharmacogenetics; preterm infant