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Captopril-associated acute interstitial nephritis.

W R Smith1, J Neill, W C Cushman

  • 1Department of Medicine, Jackson Veterans Administration Medical Center, Miss.

American Journal of Nephrology
|January 1, 1989
PubMed
Summary
This summary is machine-generated.

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Captopril, an antihypertensive drug, can cause acute kidney injury and hypersensitivity reactions, including rash and eosinophilia. Prompt cessation of captopril and potential steroid therapy may aid recovery from this interstitial nephritis.

Area of Science:

  • Nephrology
  • Pharmacology
  • Immunology

Background:

  • Angiotensin-converting enzyme (ACE) inhibitors are widely used for hypertension.
  • Diabetic glomerulosclerosis can predispose patients to renal impairment.

Observation:

  • A 57-year-old male with pre-existing renal impairment developed acute renal failure, skin rash, and eosinophilia after starting captopril.
  • Renal biopsy confirmed acute interstitial nephritis, with improvement following prednisone treatment.

Findings:

  • Literature review identified 5 similar cases of captopril-induced hypersensitivity reactions.
  • Symptoms include rash, fever, eosinophilia, azotemia, eosinophiluria, and Coombs-positive hemolytic anemia.
  • This syndrome appears specific to captopril, occurring within the first month of therapy, irrespective of dose.

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Implications:

  • Captopril-induced acute interstitial nephritis is a distinct hypersensitivity syndrome.
  • Discontinuation of captopril is crucial for recovery.
  • Steroids may accelerate recovery, but further data are needed.