Levofloxacin-induced granulomatous interstitial nephritis
Levofloxacin-induced granulomatous interstitial nephritis
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DOI：
10.1053/ajkd.2003.50064
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发表时间：
2003-02-01
影响因子：
13.2
通讯作者：
Johnson, JP
中科院分区：
文献类型：
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作者：
Ramalakshmi, S;Bastacky, S;Johnson, JP
作者报告了1例47岁女性患者，在接受左氧氟沙星治疗疑似尿路感染后发生全身性疾病，表现为发热、不适、肝功能结果异常和急性肾衰竭。由于怀疑药物过敏反应，停用所有药物，但患者持续发热伴肾衰竭18天。对假定的血管炎、自身免疫性疾病或感染性病因的完整检查为阴性，患者接受了肾脏和肝脏活检。肝活检结果显示非特异性改变。肾活检显示广泛肉芽肿性间质性肾炎伴肉芽肿性血管炎。患者开始口服类固醇，发热迅速消退，肾功能逐渐正常化。作者讨论了肉芽肿性肾炎与药物的关系，并回顾了已知的氟喹诺酮类药物的肾毒性。
The authors report the case of a 47-year-old woman in whom a systemic illness developed characterized by fever, malaise, abnormal liver function results, and acute renal failure after treatment for presumed urinary tract infection with levofloxacin. Because of suspicion of an allergic drug reaction, all medications were discontinued, but the patient remained febrile with renal failure for 18 days. Complete workup for presumed vasculitis, autoimmune illness, or infectious etiologies was negative, and the patient underwent both renal and liver biopsy. Liver biopsy results showed nonspecific changes. Renal biopsy disclosed extensive granulomatous interstitial nephritis with associated granulomatous vasculitis. The patient was begun on oral steroids with rapid defervescence of fever and progressive normalization of renal function. The authors discuss the association of granulomatous nephritis with drugs and review the known nephrotoxicity of fluoroquinolones.