Journal of Yeungnam Medical Science

Case Reports

DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs.: Soo Jin Kim, Young Hee Nam, Ji Young Juong, Eun Young Kim, Su Mi Lee, Young Ki Son, Hee Joo Nam, Ki Ho Kim, Soo Keol Lee; Yeungnam Univ J Med. 2016;33(1):59-63. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.59

Abstract PDF: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

A case of Rifampin-induced Acute Renal Failure.: Dong Hwa Lee, Te Gue Park, Je Sung Lee, Heui Sik Kim, Kyoung Hyun Kim, Young Jun Ha, Sung Bok Jung, Jun Young Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1998;15(1):173-181. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.173

Abstract PDF: Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.

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