Drug Reaction Causing Acute Tubulointerstitial Nephritis: A Molecular Mistake
4 affiliations
- 1Internal Medicine, Hospital de São João, Porto, PRT
- 2Infectious Disease, Hospital de São João, Porto, PRT
- 3Internal Medicine, Centro Hospitalar Universitário de São João, Porto, PRT
- 4Medicine, Faculdade de Medicina da Universidade do Porto, Porto, PRT
Abstract
Kidney diseases can affect different kidney structures, namely, the glomerulus, the tubules, and the interstitium. Acute tubulointerstitial nephritis (ATIN) affects both the tubules and the interstitium, initially through epithelial damage that can progress to interstitial fibrosis and tubular atrophy. There are different mechanisms that can produce ATIN, and most of them involve a renal immune response.
The case involves a 53-year-old woman with breast cancer undergoing chemotherapy and pembrolizumab who was concurrently receiving a proton pump inhibitor and antibiotic therapy for an Escherichia coli urinary tract infection. She presented with persistent acute renal injury. Initial laboratory and imaging investigations did not reveal significant abnormalities. A kidney biopsy was performed, which demonstrated histopathological findings consistent with ATIN. Corticosteroid therapy was initiated, resulting in gradual improvement of renal function.
This case aims to demonstrate the complexity of managing polymedicated patients and also shows the importance of timely diagnosis and prompt removal of the etiological agent.
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BibTeX
@article{moreira2026drug,
title = {{Drug Reaction Causing Acute Tubulointerstitial Nephritis: A Molecular Mistake}},
author = {Isabel Moreira and Mariana Gomes and Neuza Soares and Jorge S Almeida},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117286},
url = {https://europepmc.org/article/PMC/PMC13723079},
note = {CC BY},
}
RIS
TY - JOUR
TI - Drug Reaction Causing Acute Tubulointerstitial Nephritis: A Molecular Mistake
AU - Isabel Moreira
AU - Mariana Gomes
AU - Neuza Soares
AU - Jorge S Almeida
PY - 2026
DA - 2026/10/01
JO - Cureus
DO - 10.7759/cureus.117286
UR - https://europepmc.org/article/PMC/PMC13723079
AB - Kidney diseases can affect different kidney structures, namely, the glomerulus, the tubules, and the interstitium. Acute tubulointerstitial nephritis (ATIN) affects both the tubules and the interstitium, initially through epithelial damage that can progress to interstitial fibrosis and tubular atrophy. There are different mechanisms that can produce ATIN, and most of them involve a renal immune response. The case involves a 53-year-old woman with breast cancer undergoing chemotherapy and pembrolizumab who was concurrently receiving a proton pump inhibitor and antibiotic therapy for an Escherichia coli urinary tract infection. She presented with persistent acute renal injury. Initial laboratory and imaging investigations did not reveal significant abnormalities. A kidney biopsy was performed, which demonstrated histopathological findings consistent with ATIN. Corticosteroid therapy was initiated, resulting in gradual improvement of renal function. This case aims to demonstrate the complexity of managing polymedicated patients and also shows the importance of timely diagnosis and prompt removal of the etiological agent.
SN - 2168-8184
ER -