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[Acute interstitial nephritis induced by loratadine]
R Alvarez Navascués1, Z Bastardo, M Fernández Díaz
1Servicio de Nefrología Hospital San Augustín Camino de Heros, 4 33400 Avilés.
Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|October 16, 2003
Summary
A rare case of acute interstitial nephritis and renal failure linked to loratadine (an antihistamine) was reported. Prompt cessation of loratadine and corticosteroid treatment led to significant renal function recovery.
Area of Science:
- Nephrology
- Pharmacology
- Allergy and Immunology
Background:
- Acute interstitial nephritis (AIN) is a significant cause of acute kidney injury, often drug-induced.
- Loratadine, a second-generation H1 receptor antagonist, is known for its antiallergic properties and favorable safety profile.
- While numerous drugs are implicated in AIN, loratadine has not been previously reported as an etiological agent.
Observation:
- A 77-year-old male presented with acute renal failure and pruritic syndrome after ten days of loratadine therapy.
- Initial differential diagnosis included rapidly progressive glomerulonephritis; however, renal biopsy and clinical course suggested a hypersensitivity reaction.
- The patient exhibited disseminated pruritic syndrome preceding the renal failure.
Findings:
- Drug-induced acute interstitial nephritis was diagnosed, strongly suspected to be a hypersensitivity reaction to loratadine.
- Cessation of loratadine and initiation of corticosteroid therapy (prednisone) resulted in progressive improvement of renal function.
- Laboratory markers of renal function normalized within one month, with resolution of hematuria and proteinuria.
Implications:
- This case highlights loratadine as a potential, albeit rare, cause of drug-induced acute interstitial nephritis.
- It underscores the importance of considering less common drug etiologies in cases of acute kidney injury.
- The findings suggest that prompt drug withdrawal and appropriate immunosuppressive therapy can lead to favorable renal outcomes in loratadine-induced AIN.