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Piperacillin/Tazobactam-Induced Granulomatous Interstitial Nephritis in a Patient with Squamous Cell Lung Cancer

Takuya Sugiura1, Kazuo Tsuchiya2, Akane Koyano1

  • 1Department of Nephrology, Shizuoka Saiseikai General Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|April 23, 2026
PubMed

Insights

Drug-induced acute interstitial nephritis (DI-AIN) is a common cause of acute kidney injury (AKI). This case highlights tazobactam/piperacillin as a potential cause of DI-AIN, with prompt treatment leading to kidney function recovery.

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Drug-induced acute interstitial nephritis (DI-AIN) is a frequent cause of acute kidney injury (AKI).
  • Patients undergoing chemotherapy, especially with multiple drugs, are at increased risk.
  • Lung squamous cell carcinoma treatment often involves nephrotoxic agents.

Purpose of the Study:

  • To report a case of AKI caused by DI-AIN in a patient treated with carboplatin, paclitaxel, and tazobactam/piperacillin.
  • To investigate the specific drug responsible for DI-AIN using diagnostic tests.
  • To demonstrate the successful management and recovery of renal function.

Main Methods:

  • Case report of a 47-year-old male patient with lung squamous cell carcinoma.
  • Renal biopsy to evaluate kidney damage.
  • Drug lymphocyte stimulation test (DLST) to identify the causative agent.
  • Treatment with drug discontinuation and corticosteroid therapy.

Main Results:

  • Renal biopsy showed acute tubulointerstitial nephritis with eosinophilic infiltration and granulomas.
  • DLST confirmed tazobactam/piperacillin as the cause of DI-AIN.
  • Cessation of tazobactam/piperacillin and initiation of corticosteroids led to renal function recovery.

Conclusions:

  • Tazobactam/piperacillin can induce DI-AIN, a significant cause of AKI.
  • Prompt diagnosis and management, including drug withdrawal and corticosteroids, are crucial for kidney recovery.
  • This approach allowed for the safe continuation of essential chemotherapy.
Keywords:
Acute kidney injuryCancer chemotherapyCarboplatinDrug-induced interstitial nephritisPiperacillin-tazobactam

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