Onder Ali Mirza, Espinoza Veronica, Berho Mariana E, Chandar Jayanthi, Zilleruelo Gaston, Abitbol Carolyn
Department of Pediatrics, Division of Pediatric Nephrology, University of Miami Miller School of Medicine, P.O. Box 016960, Miami, FL 33156, USA.
Pediatr Nephrol. 2006 Nov;21(11):1760-4. doi: 10.1007/s00467-006-0196-1. Epub 2006 Aug 1.
Phenazopyridine (Pyridium) is a commonly used urinary tract analgesic. It has been associated with yellow skin discoloration, hemolytic anemia, methemoglobinemia, and acute renal failure, especially in patients with preexisting kidney disease. We report a 17-year-old female with vertically transmitted human immunodeficiency virus (HIV) infection, presenting with acute renal failure and methemoglobinemia following a suicidal attempt with a single 1,200 mg ingestion of Pyridium. She had no prior evidence of HIV nephropathy. The patient had a progressive nonoliguric renal failure on the 3rd day following the ingestion. She was treated with N-acetylcysteine, intravenous carnitine, and alkalinization of the urine. Her kidney biopsy revealed acute tubular necrosis with no glomerular changes. After 7 days of conservative management, she was discharged home with normal kidney function. To our knowledge, this is the second smallest amount of Pyridium overdose resulting in acute renal failure with no previous history of kidney disease.
非那吡啶（吡派酸）是一种常用的泌尿道镇痛药。它与皮肤发黄、溶血性贫血、高铁血红蛋白血症及急性肾衰竭有关，尤其是在已有肾脏疾病的患者中。我们报告一名17岁垂直传播的人类免疫缺陷病毒（HIV）感染女性，在单次服用1200mg非那吡啶自杀未遂后出现急性肾衰竭和高铁血红蛋白血症。她既往无HIV肾病证据。服药后第3天患者出现进行性非少尿型肾衰竭。她接受了N-乙酰半胱氨酸、静脉注射肉碱及尿液碱化治疗。她的肾活检显示急性肾小管坏死，无肾小球改变。经过7天的保守治疗，她出院时肾功能正常。据我们所知，这是导致急性肾衰竭且既往无肾脏疾病史的非那吡啶过量服用的第二小剂量案例。
