RESUMEN
BACKGROUND: Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillins 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. CASE PRESENTATION: 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 micromol/l. CONCLUSION: 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.
Asunto(s)
Antibacterianos/efectos adversos , Compuestos Aza/efectos adversos , Nefritis Intersticial/inducido químicamente , Quinolinas/efectos adversos , Enfermedad Aguda , Anciano , Antiinflamatorios/uso terapéutico , Biopsia , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Creatinina/sangre , Edema/inducido químicamente , Edema/patología , Eosinofilia/inducido químicamente , Eosinofilia/patología , Fluoroquinolonas , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/cirugía , Masculino , Moxifloxacino , Nefritis Intersticial/patología , Neumonectomía , Neumonía/tratamiento farmacológico , Complicaciones Posoperatorias/inducido químicamente , Complicaciones Posoperatorias/tratamiento farmacológico , Complicaciones Posoperatorias/patología , Prednisolona/uso terapéuticoRESUMEN
In patients with calcium-containing kidney stones calcium supplements are officially contraindicated. Recent studies showed a protective effect by calcium-supplementation when taken with meals, analogous to the decreased risk of kidney stones by dietary calcium due to binding of oxalate. However, because of the poor compliance, costs and the official contraindication for calcium supplements in patients with kidney stones, dietary calcium intake should be preferred whenever feasible.