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Amoxicillin-Induced Hemolytic Uremic Syndrome and Kidney Injury: A Case Report

Ashok Abraham Varughese1, Madeeha Subhan Waleed1, Radhika Pathalapti2

  • 1Internal Medicine, Lower Bucks Hospital, Bristol, USA.

Cureus
|February 7, 2025
PubMed

Insights

Amoxicillin may cause hemolytic uremic syndrome (HUS), a rare but serious kidney complication. This case highlights the importance of recognizing amoxicillin-induced HUS for prompt diagnosis and treatment.

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Amoxicillin (AMX) is a widely used antibiotic with favorable pharmacokinetics.
  • Drug-induced acute kidney injury (AKI) is a significant cause of morbidity and mortality.
  • Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy (TMA) characterized by hemolysis, thrombocytopenia, and end-organ damage.

Observation:

  • A 56-year-old woman developed AKI and HUS after receiving AMX for a tooth infection.
  • Kidney biopsy showed glomerular damage, acute tubular injury, and focal segmental glomerulonephritis.
  • The patient was diagnosed with drug-induced kidney injury and concurrent TMA.

Findings:

  • Amoxicillin-induced HUS, previously unreported, was confirmed in this patient.
  • AMX can cause AKI via acute interstitial nephritis or amoxicillin-induced crystal nephropathy (AICN).
  • Discontinuation of AMX, plasmapheresis, and hemodialysis were initiated for treatment.

Implications:

  • Physicians must be aware of the potential for AMX-induced HUS.
  • Prompt recognition and intervention are crucial for managing drug-induced kidney injury and TMA.
  • Early diagnosis and treatment can lead to reversible renal impairment and improved patient outcomes.
Keywords:
amoxcillinclinical hematologydrug induced akigeneral nephrologyhemolytic uremic syndrome (hus)internal medicine

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