Kidney non-tumor - Drug toxicity-general

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Kidney non-tumor

Tubular and interstitial diseases

Drug toxicity-general

Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 24 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

See also Acute tubular necrosis

General
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● 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
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● Stop offending drug, but some patients have delayed recovery (Am J Med Sci 2012;343:36)

Micro description
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● 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

Micro images
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Urine may have white blood cell casts

Various images

End of Kidney non-tumor > Tubular and interstitial diseases > Drug toxicity-general

Ref Updated: 8/17/12

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