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Biopsy proven acute interstitial nephritis after treatment with moxifloxacin

Christos Chatzikyrkou1, Iyas Hamwi, Christian Clajus

  • 1Department of Nephrology and Hypertension, Institute of Pathology, Medical School Hannover, Hannover, Germany. chatzikyrkou.christos@mh-hannover.de

BMC Nephrology
|August 25, 2010
PubMed
Abstract

Insights

Moxifloxacin, an antibiotic, can rarely cause acute interstitial nephritis (AIN), a reversible kidney injury. Early detection through pharmacovigilance is crucial for managing this rare side effect.

Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Acute interstitial nephritis (AIN) is a significant cause of reversible acute kidney injury.
  • Drug-induced AIN accounts for at least 70% of cases, primarily linked to penicillins and NSAIDs.
  • Quinolones are infrequently associated with AIN, with prior reports mainly involving older fluoroquinolones.

Observation:

  • A case of biopsy-proven AIN following moxifloxacin treatment is presented.
  • The patient experienced fever, rigors, and acute kidney injury requiring dialysis shortly after moxifloxacin for a respiratory infection.
  • Renal biopsy showed dense eosinophilic infiltrates and severe interstitial edema.

Findings:

  • Moxifloxacin-induced acute interstitial nephritis.
  • Successful treatment with oral prednisolone, leading to renal function recovery.
  • Patient discharged with normalized creatinine levels (107 micromol/l).

Implications:

  • Highlights the importance of pharmacovigilance in identifying rare adverse drug reactions.
  • Moxifloxacin, despite a favorable risk/benefit profile, can precipitate AIN.
  • Emphasizes the need for vigilance even with widely used medications.

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