Akimoto Tetsu, Horikoshi Ryoko, Muto Shigeaki, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Saudi J Kidney Dis Transpl. 2014 Jul;25(4):864-8. doi: 10.4103/1319-2442.135184.
We describe a 19-year-old male who developed diclofenac-induced acute interstitial nephritis (AIN). Diffuse mononuclear cell infiltration was confirmed by renal biopsy and a Gallium (Ga)-67 scintigraphy revealed diffuse uptake of the isotope in both kidneys. His renal function had gradually and promptly recovered after initiation of low-dose prednisolone (0.5 mg/kg/day). There are no established criteria for the administration of corticosteroids in the treatment of drug-induced AIN. Moreover, no clear recommendations regarding the optimal dose and duration of steroid administration in the treatment for drug-induced AIN has been established. In addition, we discuss the clinical benefit of steroid treatment and the diagnostic impact of Ga scanning on the management of drug-induced AIN.
我们描述了一名19岁男性,他患上了双氯芬酸诱导的急性间质性肾炎(AIN)。肾活检证实有弥漫性单核细胞浸润,而镓(Ga)-67闪烁扫描显示双肾均有同位素的弥漫性摄取。在开始使用低剂量泼尼松龙(0.5毫克/千克/天)后,他的肾功能逐渐且迅速恢复。在药物诱导的AIN治疗中,尚无关于使用皮质类固醇的既定标准。此外,对于药物诱导的AIN治疗中类固醇给药的最佳剂量和疗程,也未确立明确的建议。此外,我们讨论了类固醇治疗的临床益处以及Ga扫描对药物诱导的AIN管理的诊断影响。