Acute allergic interstitial nephritis

Tubulointerstitial disease Acute allergic interstitial nephritis Pamidronate Nephrocalcinosis... 

Acute allergic interstitial nephritis is the underlying cause for up to 3% of all cases of acute renal failure. Clinical manifestations of AIN typically present about 14 days after initiation of therapy and include fever, maculopapular rash, eosinophilia, pyuria, hematuria, proteinuria, and oliguria. 

Acute tubular necrosis Acute allergic interstitial nephritis... 

Acute allergic interstitial nephritis Penicillins Ciprofloxacin Nonsteroidal anti-inllammatoiy drags, cyclooxygenase-2 inhibitors Proton pump inhibitors Loop diuretics... 

Brown, muddy granular casts (highly indicative of ATN) Proteinuria (glomerulonephritis or allergic interstitial nephritis) Eosinophiluria (acute interstitial nephritis)... 

Andersen I, Sjostrom P. Ciprofloxacin can cause allergic interstitial nephritis with acute renal failure. Lakartidningen. 1991 Apr 3 88(14) 1298-9. 

Allergic interstitial nephritis—Inflammation of the interstitial region of the kidney often associated with acute onset of renal insufficiency. 

Richmond JM, Whitworth JA, Eairley KE, Kincaid-Smith P. Co-trimoxazole nephrotoxicity. Lancet. 1979 Mar 3 1 (8114) 493. Kraemer MJ, Kendall R, Hickman RO, Haas JE, Bierman CW. A generalized allergic reaction with acute interstitial nephritis following trimethoprim-sulfamethoxazole use. Annals of allergy. 1982 Dec 49(6) 323-5. 

Penicillin-induced renal toxicity is most commonly seen as allergic acute interstitial nephritis (AIN). Methicillin is the most common penicillin to induce AIN, but the use of penicillin G, ampicillin, am-oxacillin, oxacillin, and carbenicillin also can lead to the development of AIN. Typically, acute renal failure follows 1 or 2 weeks of treatment with fever or rashes sometimes occurring before overt renal dysfunction. Removal of the penicillin generally allows renal function to return to normal within a few days or weeks. AIN can also be induced by certain cephalosporins (e.g., cephalothin, cephalexin, cephradine, cefoxitin, cefotaxime) and non-/i-lactam antimicrobials (e.g., sulfonamides, rifampicin, tetracyclines, erythromycin). 

Kraemer MJ, Kendall R, Flickman RO, Flass JE, Bierman CW. A generalized allergic reaction with acute interstitial nephritis following trimethoprim-sulfamethoxazole use. Ann Allergy 1982 49 323-325. 

The diuretics can result in an acute interstitial nephritis, which may have an immunologic basis and can persist, if undetected, as a chronic lesion leading to renal insufficiency. The acute form may or may not be associated with other hallmarks of an allergic phenomenon such as fever and rash, but eosinophilia and eosi-nophiluria are often present, if looked for. Thus far, this lesion has been associated with the administration of the thiazides and furosemide, but ethacrynic acid may also be involved. Persistent hypokalemia may also... 

Urinary tract Acute allograft dysfunction, with features of allergic acute interstitial nephritis, occurred in 11 renal transplant patients who were taking co-trimoxazole for prophylaxis of Pneumocystis pneumonia. All occurred within 1 month after transplantation, and renal function improved immediately after co-trimoxazole withdrawal [186" ]. 

More severe allergic reactions to ampicillin reported lately include an anaphylactoid reaction immediately after opening an ampicillin bottle (25 ), an allergic pneumonitis (26 ) and a case of acute interstitial nephritis (27 ). 

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