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Recurrent acute renal failure with interstitial nephritis due to D-penicillamine
Abstract:
A 60-year-old man with rheumatoid arthritis, who developed acute reversible renal failure with nephrotic syndrome and tubulointerstitial nephritis in association with multiple-drug therapy, is described. The episode was ascribed to the nonsteroidal anti-inflammatory agent fenbufen, and the patient was reexposed to D-penicillamine within 6 months, reproducing the same renal lesion. There was no evidence of the glomerular lesions characteristically associated with D-penicillamine nephrotoxicity. D-penicillamine was the only drug therapy common to both episodes and it is concluded that it may cause tubulointerstitial nephritis with nephrotic syndrome.
Insights
D-penicillamine, a drug used for rheumatoid arthritis, can cause acute kidney injury, specifically tubulointerstitial nephritis with nephrotic syndrome. This reversible condition was observed in a patient undergoing multiple drug therapies.
Area of Science:
- Nephrology
- Rheumatology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) management often involves multiple medications.
- Drug-induced kidney injury is a significant concern in patients with RA.
- Nonsteroidal anti-inflammatory agents (NSAIDs) and D-penicillamine are common RA treatments with potential renal side effects.