Shima Hisato, Tashiro Manabu, Yamada Satoshi, Matsuura Motokazu, Okada Kazuyoshi, Doi Toshio, Minakuchi Jun, Kawashima Shu
Department of Kidney Disease, Kawashima Hospital, 1-39 Kitasakoichiban-cho, Tokushima, 770-0011, Japan.
Department of Nephrology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
BMC Nephrol. 2018 Mar 5;19(1):52. doi: 10.1186/s12882-018-0854-0.
Cilostazol is an antiplatelet drug that is widely prescribed for the prevention of secondary stroke. Adverse reactions to cilostazol include headaches, palpitations, and diarrhea. Little is known about the nephrotoxicity of cilostazol, such as acute kidney injury. We report a biopsy-proven case of diffuse tubulointerstitial nephritis induced by cilostazol.
A 69-year-old woman prescribed cilostazol was hospitalized for acute kidney injury. On admission, her renal function deteriorated, with an increased serum creatinine level. Urinalysis showed hematuria, proteinuria, and hyper-beta2-microglobulinuria. A renal biopsy revealed diffuse tubulointerstitial nephritis associated with IgA nephropathy, and gallium-67 scintigraphy showed uptake in the bilateral kidneys. A drug lymphocyte stimulation test for cilostazol was positive, and the patient was diagnosed with cilostazol-induced acute tubulointerstitial nephritis. Despite discontinuation of cilostazol, her renal function rapidly worsened and steroid pulse therapy was initiated, followed by oral high-dose glucocorticoid therapy. After steroid treatment, her serum creatinine level normalized in parallel with urine beta2-microglobulin.
Cilostazol can induce acute tubulointerstitial nephritis.
西洛他唑是一种抗血小板药物，广泛用于预防二次中风。西洛他唑的不良反应包括头痛、心悸和腹泻。关于西洛他唑的肾毒性，如急性肾损伤，人们了解甚少。我们报告一例经活检证实由西洛他唑引起的弥漫性肾小管间质性肾炎病例。
一名因服用西洛他唑而住院治疗急性肾损伤的69岁女性。入院时，她的肾功能恶化，血清肌酐水平升高。尿液分析显示血尿、蛋白尿和高β2-微球蛋白尿。肾活检显示弥漫性肾小管间质性肾炎伴IgA肾病，镓-67闪烁扫描显示双侧肾脏有摄取。西洛他唑药物淋巴细胞刺激试验呈阳性，该患者被诊断为西洛他唑引起的急性肾小管间质性肾炎。尽管停用了西洛他唑，但她的肾功能迅速恶化，于是开始进行类固醇冲击治疗，随后进行口服高剂量糖皮质激素治疗。类固醇治疗后，她的血清肌酐水平与尿β2-微球蛋白同时恢复正常。
西洛他唑可诱发急性肾小管间质性肾炎。
