Shao Emily Ximin, Wilson Gregory John, Ranganathan Dwarakanathan
University of Sydney, Sydney, New South Wales, Australia.
Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
BMJ Case Rep. 2017 Mar 9;2017:bcr2017219452. doi: 10.1136/bcr-2017-219452.
Acute interstitial nephritis (AIN) has a number of medication-related aetiologies. Antibiotics, proton pump inhibitors and non-steroidal anti-inflammatory drugs are common causes; however, any medication has the potential to cause drug-induced AIN. We report the first case of phentermine-induced AIN. A Caucasian woman aged 43 years presented with a 5-week history of lethargy, left-sided lower abdominal pain, nausea and vomiting. She had been taking phentermine for weight loss for 9 months and had recently ceased the medication. The patient underwent a renal biopsy that showed a predominantly lymphohistiocytic interstitial infiltrate with a moderate number of eosinophils consistent with AIN. Phentermine is increasingly used for weight loss in obese patients. This is the first case implicating phentermine as the causative agent for drug-induced AIN. While rare, phentermine-induced AIN is a possible adverse reaction of phentermine. Physicians and patients need to be aware of this risk.
急性间质性肾炎（AIN）有多种与药物相关的病因。抗生素、质子泵抑制剂和非甾体抗炎药是常见病因；然而，任何药物都有可能导致药物性AIN。我们报告首例芬特明诱发的AIN。一名43岁的白人女性出现了为期5周的乏力、左下腹部疼痛、恶心和呕吐症状。她服用芬特明减肥已有9个月，最近停药。该患者接受了肾活检，结果显示以淋巴细胞-组织细胞为主的间质浸润，伴有中等数量的嗜酸性粒细胞，符合AIN表现。芬特明越来越多地用于肥胖患者的减肥。这是首例表明芬特明为药物性AIN致病因素的病例。虽然罕见，但芬特明诱发的AIN是芬特明可能的不良反应。医生和患者需要意识到这种风险。
