Kidney nontumor
Tubulointestitial disease
Other tubular and interstitial disease
Drug toxicity-general


Topic Completed: 3 December 2012

Minor changes: 30 June 2020

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PubMed Search: Drug toxicity [title] kidney

Related Topic: Acute tubular necrosis

Nikhil Sangle, M.D.
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Cite this page: Sangle N. Drug toxicity-general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneydrugtoxicity.html. Accessed October 20th, 2020.
Definition / general
  • Acute drug-induced interstitial nephritis, typically arises 15 days after exposure, non dosage related
  • May be a delayed (type IV) hypersensitivity reaction, due to hapten like effect of drug, which binds to tubular epithelium, making it immunogenic
  • Rash, fever, eosinophilia, hematuria, mild proteinuria
  • 50% have rising creatinine or develop acute renal failure
  • Common offending drugs are cimetidine, penicillin, phenylbutzaone, rifampin, thiazides
Treatment
Microscopic (histologic) description
  • Edematous interstitium containing abundant eosinophils and neutrophils, lymphocytes, macrophages
  • Also basophils and plasma cells, occasionally granulomas after methicillin
  • Tubular necrosis and regeneration present; glomeruli are normal
Microscopic (histologic) images

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