Hayashi Daichi, Nishida Tsutomu, Osugi Naoto, Kusunoki Yasuo, Okabe Satoru, Fujii Yoshifumi, Nakamatsu Dai, Matsumoto Kengo, Yamamoto Masashi, Fukui Koji
Department of Gastroenterology, Toyonaka Municipal Hospital, Japan.
Division of Nephrology, Department of Internal Medicine, Toyonaka Municipal Hospital, Japan.
Intern Med. 2024 Apr 15;63(8):1081-1085. doi: 10.2169/internalmedicine.2366-23. Epub 2023 Sep 1.
This report describes the case of a 76-year-old man with ulcerative colitis who developed interstitial nephritis after starting 5-Aminosalicylic acid (5-ASA) therapy. The patient experienced an initial improvement in symptoms, but developed fatigue, anorexia, and severe renal dysfunction 2.5 months later. Renal biopsy confirmed drug-induced interstitial nephritis, and conservative treatment with fluid replacement and the discontinuation of 5-ASA improved the patient's condition. Clinicians should monitor patients receiving 5-ASA therapy for potential adverse effects, particularly renal injury, and promptly investigate symptoms of renal dysfunction. Early recognition and discontinuation of the offending agent may prevent further damage and improve patient outcomes.
本报告描述了一名76岁溃疡性结肠炎男性患者的病例,该患者在开始使用5-氨基水杨酸(5-ASA)治疗后发生间质性肾炎。患者症状最初有所改善,但2.5个月后出现疲劳、厌食和严重肾功能不全。肾活检证实为药物性间质性肾炎,通过补液和停用5-ASA进行保守治疗后患者病情好转。临床医生应对接受5-ASA治疗的患者监测潜在不良反应,尤其是肾损伤,并及时调查肾功能不全的症状。早期识别并停用致病药物可能预防进一步损害并改善患者预后。