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Acute interstitial nephritis due to pantoprazole
1Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
The Annals of Pharmacotherapy
|January 27, 2004
Summary
This case report details acute interstitial nephritis (AIN) in a patient taking pantoprazole. Early detection of this rare adverse reaction to proton-pump inhibitors is crucial for preventing kidney damage.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Acute interstitial nephritis (AIN) is an inflammatory kidney condition often caused by drug hypersensitivity.
- Proton-pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
- While omeprazole has been linked to AIN, other PPIs are less commonly reported.
Observation:
- A 77-year-old woman developed AIN after initiating pantoprazole for gastroesophageal reflux.
- Symptoms included elevated creatinine, oliguria, flank pain, and eosinophils in urine.
- Renal biopsy confirmed AIN, with a highly probable link to pantoprazole therapy.
Findings:
- Pantoprazole discontinuation led to gradual improvement in renal function.
- Corticosteroid therapy (prednisone) was initiated, potentially aiding renal recovery.
- The Naranjo scale indicated a strong association between pantoprazole and AIN in this patient.
Implications:
- This case highlights pantoprazole as a potential cause of drug-induced AIN.
- Awareness of PPI-associated AIN is important for early diagnosis and intervention.
- Prompt recognition and management can prevent severe acute renal insufficiency.