Biopsy proven acute interstitial nephritis after treatment with moxifloxacin

Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillines and non-steroidal anti-inflammatory drugs.

Quinolones are only rarely known to cause AIN and so far cases have been mainly described with older fluoroquinolones.Case Presentation: Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors and dialysis dependent acute kidney injury, just a few days after treatment of a respiratory tract infection with moxifloxacin.

The renal biopsy revealed dense infiltrates mainly composed of eosinophils and severe interstitial edema. A course of oral prednisolone (1mg/kg/day) was commenced and rapidly tapered to zero within three weeks.

The renal function improved, and the patient was discharged with a creatinine of 107mumol/l.

Conclusion: This case illustrates that pharmacovigilance is important to early detect rare side effects, such as AIN, even in drugs with a favourable risk/benefit ratio such as moxifloxacin.

Author: Christos ChatzikyrkouIyas HamwiChristian ClajusJan BeckerCarsten HaferJan Kielstein
Credits/Source: BMC Nephrology 2010, 11:19

Published on: 2010-08-23

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