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Acute interstitial nephritis with acetaminophen and alcohol intoxication
Lauren L Fruchter1, Iakovina Alexopoulou, Keith K Lau
1Faculty of Health Sciences, McMaster University, Ontario, Canada.
Italian Journal of Pediatrics
|April 19, 2011
Summary
Acetaminophen overdose can cause acute interstitial nephritis (AIN), a form of kidney failure. This case highlights acetaminophen and alcohol
Area of Science:
- Nephrology
- Toxicology
- Pharmacology
Background:
- Drug-induced acute interstitial nephritis (AIN) is an increasing cause of renal failure.
- Antimicrobials and NSAIDs are common culprits, but other analgesics are less frequently reported.
- Acetaminophen is a common over-the-counter analgesic with known renal and hepatic toxicity at high doses.
Observation:
- A 17-year-old female presented with AIN and renal injury after an acetaminophen overdose.
- The patient also had acute alcohol intoxication.
- Acetaminophen metabolism generates reactive metabolites implicated in organ toxicity.
Findings:
- This case suggests acetaminophen, even when not typically associated with AIN, can induce this condition.
- Reactive acetaminophen metabolites may alter renal peptide immunogenicity, triggering AIN.
- Acute alcohol ingestion may play a role in the onset of acetaminophen-induced AIN.
Implications:
- Healthcare professionals should be aware of acetaminophen's potential to cause AIN.
- The combined effect of acetaminophen and alcohol in AIN pathogenesis warrants further investigation.
- Increased awareness can improve diagnosis and management of drug-induced kidney injury.
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