Henao Justine, Hisamuddin Irfan, Nzerue Chike M, Vasandani Geetanjali, Hewan-Lowe Karlene
Department of Medicine, Morehouse School of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Am J Kidney Dis. 2002 Jun;39(6):1313-7. doi: 10.1053/ajkd.2002.33412.
Data about the nephrotoxicity of selective cyclooxygenase-2 inhibitors are still evolving. Acute interstitial nephritis is a well-described complication of therapy with nonselective nonsteroidal anti-inflammatory drugs. We report a case of biopsy-proven acute interstitial nephritis in a 73-year-old diabetic woman, who had taken celecoxib for more than 1 year before presentation. She presented with clinical findings of subnephrotic proteinuria and acute renal failure that required dialysis. She recovered renal function with cessation of celecoxib therapy after 2 weeks. Other medications were reintroduced safely, without recurrence of renal failure. A kidney biopsy specimen showed acute interstitial nephritis with a prominent eosinophilic infiltrate in the interstitium. This case documents the occurrence of acute interstitial nephritis with celecoxib and emphasizes the need for continued vigilance and care in use of cyclooxygenase-2 inhibitors in high-risk patients.
关于选择性环氧化酶-2抑制剂肾毒性的数据仍在不断演变。急性间质性肾炎是使用非选择性非甾体抗炎药治疗时一种广为人知的并发症。我们报告一例经活检证实的急性间质性肾炎病例,患者为一名73岁的糖尿病女性,在就诊前服用塞来昔布超过1年。她出现了亚肾病性蛋白尿和急性肾衰竭的临床表现,需要进行透析。在停用塞来昔布治疗2周后,她的肾功能恢复。其他药物安全重新使用,未再出现肾衰竭。肾脏活检标本显示急性间质性肾炎,间质中有显著的嗜酸性粒细胞浸润。该病例记录了塞来昔布导致急性间质性肾炎的发生,并强调在高危患者中使用环氧化酶-2抑制剂时需要持续保持警惕和谨慎。