Sarcletti M, Zangerle R
Department of Dermatology and Venereology, University of Innsbruck, Austria.
AIDS Patient Care STDS. 1999 Feb;13(2):81-7. doi: 10.1089/apc.1999.13.81.
This case report describes a 32-year-old woman treated with indinavir who developed mild to moderate flank pain, malaise, and low-grade fever. Sterile pyuria preceded increased serum creatinine levels. Workup revealed persistent pyuria, normal-sized kidneys, a normal intravenous pyelography, and negative urinary cultures. Renal biopsy showed interstitial nephritis and chronic inflammation. Collecting ducts contained crystals. Two months after treatment with indinavir was discontinued, serum creatinine levels returned to normal and pyuria disappeared. Sterile pyuria in patients taking indinavir may help to identify patients at risk for renal dysfunction and interstitial nephritis. Markedly increasing the fluid intake above the recommended dosage may ameliorate or even reverse the process of tubulointerstitial disease.
本病例报告描述了一名32岁接受茚地那韦治疗的女性，她出现了轻至中度的胁腹疼痛、不适和低热。无菌性脓尿先于血清肌酐水平升高出现。检查发现持续性脓尿、肾脏大小正常、静脉肾盂造影正常以及尿培养阴性。肾活检显示间质性肾炎和慢性炎症。集合管内有结晶。停用茚地那韦治疗两个月后，血清肌酐水平恢复正常，脓尿消失。服用茚地那韦的患者出现无菌性脓尿可能有助于识别有肾功能障碍和间质性肾炎风险的患者。显著增加液体摄入量使其高于推荐剂量可能改善甚至逆转肾小管间质性疾病的进程。
