Aggarwal Sunita, Garg Chetan, Kumar Shanu, Singh Ranvijay
General Medicine, Maulana Azad Medical College, New Delhi, India
General Medicine, Maulana Azad Medical College, New Delhi, India.
BMJ Case Rep. 2023 Mar 14;16(3):e254226. doi: 10.1136/bcr-2022-254226.
Granulomatous interstitial nephritis (GIN) is a type of tubulointerstitial nephritis characterised by tubulointerstitial infiltration of mononuclear cells and eosinophils. It accounts for about 6% of all tubulointerstitial nephritis and is detected in ∼0.5%-0.9% of all renal biopsies. GIN has been linked to several antibiotics, non steroidal anti-inflammatory drugs (NSAIDs), and granulomatous disorders like tuberculosis and sarcoidosis but is rarely reported with anti-epileptic medications like phenytoin and levetiracetam. We present a case report of a man in his early 20's with previously normal renal function who developed GIN following levetiracetam and phenytoin consumption for 7 years. After withdrawal of the causative drug and starting steroid therapy, his kidney function gradually improved. In cases of GIN, medication history is important in the evaluation of aetiology.
肉芽肿性间质性肾炎（GIN）是一种肾小管间质性肾炎，其特征是肾小管间质有单核细胞和嗜酸性粒细胞浸润。它约占所有肾小管间质性肾炎的6%，在所有肾活检中约0.5%-0.9%被检测到。GIN与多种抗生素、非甾体抗炎药（NSAIDs）以及肉芽肿性疾病如结核病和结节病有关，但很少有与苯妥英钠和左乙拉西坦等抗癫痫药物相关的报道。我们报告一例20岁出头的男性病例，其既往肾功能正常，在服用左乙拉西坦和苯妥英钠7年后发生了GIN。停用致病药物并开始类固醇治疗后，他的肾功能逐渐改善。在GIN病例中，用药史在病因评估中很重要。
