Drug-induced interstitial nephritis in a 9-year-old child: A case report

Drug-induced acute interstitial nephritis (DI-AIN) is a common cause of AKI. Di-AIN diagnosis relies on clinical suspicion and renal biopsy to diagnose it. The occurrence of AIN in patients receiving antimicrobial therapy is rarely reported in children. In the present study, we present a child with a diagnosis of acute interstitial drug-induced nephritis.Case presentation:A 9-year-old girl with complaints of recurrent seizures. The patient had a history of seizures from 3.5 years of age and was treated with phenobabital until 8 years of age. Patient was febrile (T = 39 ° C). Vancomycin, cefotaxime, Phenobarbital and acyclovir were started. The patient s serum creatinine concentration was 0.5 mg / dl. 6 days after starting antibiotics, the patient s serum creatinine concentration reached 3.3 mg / dL. Therefore, given the strong clinical suspicion of DI-AIN, all antibiotics were discontinued 4 days after the elevated serum creatinine concentration. Following fluid therapy, the patient s serum creatinine concentration returned to normal within 2 weeks after discontinuation of antibiotics (Cr = 0.6 mg / dl). Patient follow-up was normal for 6 weeks after discharge. Therefore, there was no need for a kidney biopsy.Discussion and conclusion:In a similar, 6 children with DI-AIN were reported to have symptoms of AIN 2 to 4 weeks after antibiotic use. Also, few studies have reported the incidence of DI-AIN following vancomycin use in children. In only one case study, DI-AIN followed by cefotaxime in a 28-year-old man was reported. In 1990 a study of 3 children with acute renal failure following acyclovir administration was reported. Therefore, it seems that according to the patient s symptoms, the drug that cause DI-AIN cannot be identified. Therefore, physicians should be careful about the occurrence of DI-AIN in children with cefotaxime, vancomycin, and acyclovir.

Keywords:

DI-AIN , cefotaxime , vancomycin , acyclovir , children