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Acute interstitial nephritis due to methicillin

J E Galpin, J H Shinaberger, T M Stanley

    The American Journal of Medicine
    |November 1, 1978
    PubMed
    Summary

    Methicillin antibiotic use can cause severe kidney dysfunction, characterized by interstitial nephritis, sterile pyuria, and eosinophiluria. Prednisone therapy may accelerate recovery from methicillin-induced kidney injury.

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    Area of Science:

    • Nephrology
    • Pharmacology
    • Pathology

    Background:

    • Methicillin is an antibiotic known to cause adverse renal effects.
    • Interstitial nephritis is a kidney condition that can lead to severe renal dysfunction.
    • Identifying drug-induced kidney injury is crucial for timely intervention.

    Purpose of the Study:

    • To describe the clinical, laboratory, and pathological features of methicillin-induced interstitial nephritis.
    • To evaluate the efficacy of prednisone treatment in patients with this condition.

    Main Methods:

    • Case series describing 14 patients with methicillin-induced interstitial nephritis.
    • Analysis of clinical presentation, laboratory findings (serum creatinine, peripheral eosinophil count, urinalysis), and renal biopsy findings (light microscopy, electron microscopy, immunofluorescence).

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  • Comparison of recovery rates between patients treated with prednisone and those not treated.

    • Main Results:

    • All 14 patients developed severe renal dysfunction (average peak serum creatinine 8 mg/100 ml).
    • Consistent findings included peripheral eosinophilia, sterile pyuria, and marked eosinophiluria.
    • Prednisone treatment was associated with a statistically shorter time to recovery of renal function compared to no treatment.

    Conclusions:

    • Methicillin-induced interstitial nephritis is a distinct syndrome characterized by specific clinical and laboratory findings.
    • Renal biopsy findings provide further evidence for this diagnosis.
    • Prednisone therapy appears to be beneficial in accelerating recovery from methicillin-induced kidney injury.