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Atypical presentation of allergic interstitial nephritis likely induced by ciprofloxacin
  1. Ronald Valdez Imbert1,
  2. Miroslav Sekulic2,
  3. Pir Saad3 and
  4. Belinda Jim1
  1. 1Department of Medicine, Jacobi Medical Center at Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA
  3. 3Department of Medicine, Griffin Hospital, Derby, Connecticut, USA
  1. Correspondence to Dr Belinda Jim; belindajim286{at}gmail.com

Abstract

Though the prevalence of drug induced allergic interstitial nephritis (AIN) appears to be increasing, the diagnostic and treatment strategies still remain vague. We present a 56-year-old man with a history of hypertension, chronic kidney disease stage IIIa, recent exposure to ciprofloxacin who presented with acute kidney injury. Though the suspicion of AIN was high, his urinary sediment was bland, that is, no leucocytes or leucocyte casts. A renal biopsy subsequently showed features of AIN correlating with a resolving phase of inflammation. Given the resolving nature of the pathology, we chose not to complete a course of corticosteroids despite his need for temporary haemodialysis. He was able to fully recover his renal function. In this report, we emphasise the unreliable nature of the urinary sediment in the diagnosis of AIN, the utility of a renal biopsy in helping to guide treatment, and the controversial data in corticosteroid treatment.

  • renal system
  • unwanted effects / adverse reactions
  • acute renal failure
  • proteinurea
  • renal intervention

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Footnotes

  • Contributors RIV collected clinical data, analysed the data and prepared the manuscript. MS interpreted the pathology findings and aided in preparation of manuscript. PS helped to research and prepare the manuscript. BJ helped to analyse the data and prepared the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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