Biopsy proven acute interstitial nephritis after treatment with moxifloxacin.
Biopsy proven acute interstitial nephritis after treatment with moxifloxacin.
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DOI：
10.1186/1471-2369-11-19
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发表时间：
2010-08-23
期刊：
影响因子：
2.3
通讯作者：
Kielstein JT
中科院分区：
文献类型：
--
作者：
Chatzikyrkou C;Hamwi I;Clajus C;Becker J;Hafer C;Kielstein JT
急性间质性肾炎（AIN）是可逆性急性肾损伤的重要病因。至少70%的AIN是由多种药物引起的，主要是青霉素类和非甾体类抗炎药。喹诺酮类药物很少引起AIN，到目前为止，病例主要描述为使用较老的氟喹诺酮类药物。我们在此报告一例经莫西沙星治疗后活检证实为间质性肾炎的病例。患者在用莫西沙星治疗呼吸道感染几天后出现发烧、僵硬和透析依赖性急性肾损伤。肾活检显示主要由嗜酸性粒细胞组成的致密浸润和严重的间质水肿。开始口服强的松龙一个疗程（1mg /kg/天），并在三周内迅速逐渐减少到零。肾功能改善，出院时肌酐为107 μmol/l。这个病例说明，药物警戒对于早期发现罕见的副作用（如AIN）是很重要的，即使是对莫西沙星等具有良好风险/效益比的药物也是如此。
Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillines and non-steroidal anti-inflammatory drugs. Quinolones are only rarely known to cause AIN and so far cases have been mainly described with older fluoroquinolones. Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors and dialysis dependent acute kidney injury, just a few days after treatment of a respiratory tract infection with moxifloxacin. The renal biopsy revealed dense infiltrates mainly composed of eosinophils and severe interstitial edema. A course of oral prednisolone (1 mg/kg/day) was commenced and rapidly tapered to zero within three weeks. The renal function improved, and the patient was discharged with a creatinine of 107 μmol/l. This case illustrates that pharmacovigilance is important to early detect rare side effects, such as AIN, even in drugs with a favourable risk/benefit ratio such as moxifloxacin.
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