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Levofloxacin-induced granulomatous interstitial nephritis
Santhanam Ramalakshmi1, Sheldon Bastacky, John P Johnson
1Departments of Medicine and Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Summary
A woman developed acute kidney injury after levofloxacin treatment. Renal biopsy revealed granulomatous interstitial nephritis, suggesting a drug-induced hypersensitivity reaction.
Area of Science:
- Nephrology
- Pharmacology
- Pathology
Background:
- Levofloxacin, a fluoroquinolone antibiotic, is commonly prescribed for urinary tract infections.
- Drug-induced hypersensitivity reactions can manifest with diverse systemic symptoms, including renal dysfunction.
Observation:
- A 47-year-old woman presented with fever, malaise, abnormal liver function, and acute renal failure post-levofloxacin therapy.
- Despite medication cessation, persistent fever and renal failure prompted extensive workup for autoimmune, infectious, and vasculitic causes, all yielding negative results.
Findings:
- Renal biopsy revealed extensive granulomatous interstitial nephritis and vasculitis.
- Treatment with oral steroids led to rapid fever resolution and improved renal function.
Implications:
- This case highlights granulomatous interstitial nephritis as a potential adverse reaction to levofloxacin.
- The findings underscore the importance of considering drug-induced nephrotoxicity in cases of unexplained renal failure.
- Further research into fluoroquinolone-associated nephrotoxicity and hypersensitivity is warranted.