Kitahara T, Hiromura K, Sugawara M, Hirato J, Sato S, Ueki K, Maezawa A, Yano S, Nojima Y, Naruse T
Third Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Am J Kidney Dis. 1999 Feb;33(2):E7. doi: 10.1016/s0272-6386(99)70328-8.
We present a case of acute tubulointerstitial nephritis (ATIN) that developed in a 63-year-old man who had been taking cimetidine for treatment of a gastric ulcer. The constellation of clinical, laboratory, and histopathologic findings suggested drug-induced ATIN. Of interest, the patient had antineutrophil cytoplasmic antibody (ANCA) in his sera, reactive with myeloperoxidase, elastase, and lactoferrin. Prominent renal histological features included marked plasmacyte infiltration into the renal interstitium. Withdrawal of cimetidine resulted in complete resolution of renal findings, and the titers of ANCA concomitantly declined. Thus, cimetidine may have played a causative role in the development of ANCA-associated ATIN.
我们报告一例急性肾小管间质性肾炎（ATIN），该病例发生在一名63岁的男性身上，他一直在服用西咪替丁治疗胃溃疡。临床、实验室和组织病理学检查结果提示为药物性ATIN。有趣的是，患者血清中存在抗中性粒细胞胞浆抗体（ANCA），与髓过氧化物酶、弹性蛋白酶和乳铁蛋白反应。突出的肾脏组织学特征包括肾间质显著的浆细胞浸润。停用西咪替丁后，肾脏检查结果完全恢复，ANCA滴度也随之下降。因此，西咪替丁可能在ANCA相关的ATIN发病中起了致病作用。
