A CASE OF ACUTE RENAL FAILURE DUE TO ACUTE INTERSTITIAL NEPHRITIS

Abstract

A 28-year-old man who had been treated with several kinds of antibiotics and antipyretics for acute tonsillitis developed acute renal failure with high fever, generalized skin rush and eosinophilia. He was treated successfully by administration of adrenal corticosteroids and peritoneal dialysis. Kidney biopsy demonstrated diffuse interstitial infiltration with small lymphocytes, plasma cells and polymorphonuclear leukocytes with relatively intact tubules, vessels and glomeruli, which was compatible with acute interstitial nephritis. Immunofluorescence studies of biopsied kidney sections revealed no deposition of IgG, IgM, IgA or β₁C. Repeated blood and urine cltures were negative for bacteria. The findings may support the suggestion that delayed-type hypersensitivity is the cause of the acute interstitial nephritis, and the drugs used in this patient such as cephalexin, cephalothin or aminopyrine were suspected to be the cause of the delayed-type hypersensitivity.