Tubulointerstitial nephritis associated with pyrazinamide

Modern antituberculous therapy consists of a combination of several drugs, some of which (e.g. rifampicin and streptomycin) may cause impairment of renal function. Pyrazinamide therapy has been associated with dose-dependent hepatotoxicity, hyperuricaemia, arthralgia and arthritis. The patient described in this report developed renal failure, fever, arthritis and arthralgia during administration of isoniazid, rifampicin, streptomycin and pyrazinamide. The renal biopsy showed tubulo-interstitial nephritis. After withdrawal of pyrazinamide, while continuing all other drugs, both renal function and histological findings improved which points to an association of renal failure with pyrazinamide.