2018 Volume 31 Issue 1 Pages 30-36
Seven girls (age, 4–13 years) with elevated serum creatinine (Cr) and presumed Mycoplasma pneumoniae infection were treated with 4–7 doses of tosufloxacin (TFLX) in a correct manner. Whereas four of the patients met the criteria for acute kidney injury, only one patient had elevated serum cystatin C. The elevated Cr normalized in all patients after TFLX withdrawal. Two patients had a history of treatment with TFLX; one had similar Cr elevation and abdominal pain two months previously and the other, who had received over 100 doses of TFLX over the past last five years, tended to have increased Cr even in the absence of TFLX. Four of the patients developed abdominal pain, nausea and loss of appetite that improved within two days. Computer tomography and magnetic resonance imaging revealed thickening of the small intestine and ascites accumulation. The pathophysiological mechanism of acute kidney damage under TFLX administration is thought to be cast nephropathy, but information about the adverse effects of TFLX is scant. We hope to resolve these issues and develop an optimal standard for TFLX administration.
