Kidney nontumor
Other tubular and interstitial disease
Drug toxicity-general

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 26 November 2018, last major update December 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Drug toxicity [title] kidney

Related Topic: Acute tubular necrosis
Cite this page: Sangle, N. Drug toxicity-general. website. Accessed December 16th, 2018.
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
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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Urine may have white
blood cell casts

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Various images