Goli R, Mukku K K, Raju S B, Uppin M S
Department of Nephrology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India.
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India.
Indian J Nephrol. 2017 May-Jun;27(3):231-233. doi: 10.4103/0971-4065.200522.
Crystal-induced acute kidney injury (AKI) is caused by the intratubular precipitation of crystals, which results in obstruction and kidney injury. Ciprofloxacin, a commonly used antibiotic, causes AKI secondary to immune-mediated interstitial injury. Rare mechanisms of ciprofloxacin-induced renal injury include crystalluria, rhabdomyolysis, and granulomatous interstitial nephritis. Clinical and experimental studies have suggested that crystalluria and crystal nephropathy due to ciprofloxacin occur in alkaline urine. Preexisting kidney function impairment, high dose of the medication, and advanced age predispose to this complication. We report a case of ciprofloxacin-induced crystal nephropathy and granulomatous interstitial nephritis in a young patient with no other predisposing factors. The patient responded to conservative treatment without the need for glucocorticoids.
晶体诱导的急性肾损伤（AKI）是由肾小管内晶体沉淀引起的，这会导致梗阻和肾损伤。环丙沙星是一种常用抗生素，可导致继发于免疫介导的间质性损伤的AKI。环丙沙星诱导肾损伤的罕见机制包括结晶尿、横纹肌溶解和肉芽肿性间质性肾炎。临床和实验研究表明，环丙沙星导致的结晶尿和晶体肾病发生于碱性尿液中。既往存在的肾功能损害、高剂量用药和高龄易引发此并发症。我们报告一例年轻患者发生环丙沙星诱导的晶体肾病和肉芽肿性间质性肾炎，该患者无其他易感因素。患者对保守治疗有反应，无需使用糖皮质激素。
