Antiepileptic drug-induced severe granulomatous interstitial nephritis. 2023

Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
General Medicine, Maulana Azad Medical College, New Delhi, India drsunita.mamc@gmail.com.

Granulomatous interstitial nephritis (GIN) is a type of tubulointerstitial nephritis characterised by tubulointerstitial infiltration of mononuclear cells and eosinophils. It accounts for about 6% of all tubulointerstitial nephritis and is detected in ∼0.5%-0.9% of all renal biopsies. GIN has been linked to several antibiotics, non steroidal anti-inflammatory drugs (NSAIDs), and granulomatous disorders like tuberculosis and sarcoidosis but is rarely reported with anti-epileptic medications like phenytoin and levetiracetam. We present a case report of a man in his early 20's with previously normal renal function who developed GIN following levetiracetam and phenytoin consumption for 7 years. After withdrawal of the causative drug and starting steroid therapy, his kidney function gradually improved. In cases of GIN, medication history is important in the evaluation of aetiology.

UI MeSH Term Description Entries
D008297 Male Males
D009395 Nephritis, Interstitial Inflammation of the interstitial tissue of the kidney. This term is generally used for primary inflammation of KIDNEY TUBULES and/or surrounding interstitium. For primary inflammation of glomerular interstitium, see GLOMERULONEPHRITIS. Infiltration of the inflammatory cells into the interstitial compartment results in EDEMA, increased spaces between the tubules, and tubular renal dysfunction. Interstitial Nephritis,Nephritis, Tubulointerstitial,Tubulointerstitial Nephritis,Interstitial Nephritides,Nephritides, Interstitial,Nephritides, Tubulointerstitial,Tubulointerstitial Nephritides
D010672 Phenytoin An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. Diphenylhydantoin,Fenitoin,Phenhydan,5,5-Diphenylhydantoin,5,5-diphenylimidazolidine-2,4-dione,Antisacer,Difenin,Dihydan,Dilantin,Epamin,Epanutin,Hydantol,Phenytoin Sodium,Sodium Diphenylhydantoinate,Diphenylhydantoinate, Sodium
D006099 Granuloma A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Granulomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077287 Levetiracetam A pyrrolidinone and acetamide derivative that is used primarily for the treatment of SEIZURES and some movement disorders, and as a nootropic agent. Etiracetam,Etiracetam, (R)-,Etiracetam, R-isomer,Etiracetam, S-isomer,Keppra,UCB 6474,UCB-6474,Ucb L059,Ucb L060,Ucb-L059,Ucb-L060,alpha-ethyl-2-oxo-1-Pyrrolidineacetamide,Etiracetam, R isomer,Etiracetam, S isomer,R-isomer Etiracetam,S-isomer Etiracetam,UCB6474,UcbL060,alpha ethyl 2 oxo 1 Pyrrolidineacetamide
D000927 Anticonvulsants Drugs used to prevent SEIZURES or reduce their severity. Anticonvulsant,Anticonvulsant Drug,Anticonvulsive Agent,Anticonvulsive Drug,Antiepileptic,Antiepileptic Agent,Antiepileptic Agents,Antiepileptic Drug,Anticonvulsant Drugs,Anticonvulsive Agents,Anticonvulsive Drugs,Antiepileptic Drugs,Antiepileptics,Agent, Anticonvulsive,Agent, Antiepileptic,Agents, Anticonvulsive,Agents, Antiepileptic,Drug, Anticonvulsant,Drug, Anticonvulsive,Drug, Antiepileptic,Drugs, Anticonvulsant,Drugs, Anticonvulsive,Drugs, Antiepileptic
D051437 Renal Insufficiency Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE. Kidney Insufficiency,Kidney Failure,Renal Failure,Failure, Kidney,Failure, Renal,Failures, Kidney,Failures, Renal,Insufficiency, Kidney,Kidney Failures,Kidney Insufficiencies,Renal Failures,Renal Insufficiencies

Related Publications

Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
January 1983, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
June 2012, Clinical kidney journal,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
December 2015, BMC research notes,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
February 2007, Pediatric nephrology (Berlin, Germany),
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
February 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
April 1988, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
January 2006, Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
April 2002, Clinical nephrology,
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
February 1988, Presse medicale (Paris, France : 1983),
Sunita Aggarwal, and Chetan Garg, and Shanu Kumar, and Ranvijay Singh
January 1984, Advances in nephrology from the Necker Hospital,
Copied contents to your clipboard!