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| 비스테로이드성 소염진통제에 의한 급성 간질성 신염 1예 |
| 차대룡 , 구자룡 , 김선숙 , 조원용 , 김형규 , 원남희 , 노정우 |
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| Abstract |
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The use of NSAIDs have been increased in many countries, and so the renal toxicities resulting from NSAIDs also are increasing in a tendency. NSAIDs may be cause a deterioration of renal function through a lot of the different mechanisms. Renal toxicities of NSAIDs are variable such as which acute renal failure due to the enhanced vasoconstriction, acute interstitial nephritis, sodium and water retention that of an antinatriuretic effect of prostaglandin synthesis is inhibited, and an enhanced ADH effect from prostaglandin synthesis in- hibition, and a hyperkalemia due to hyporeninemic hypoaldosteronism. Recently authors experienced a case of NSAID induced acute interstitial nephritis with minimal change nephrotic syndrome. This patient is a 54 years old female who developed a generalized edema, heavy proteinuria and renal insufficiency after taking proprionic acid derivatives for three months. Biopsy of kidney revealed mononuclear cell infiltration in the interstitium, renal tubular atrophy with degenerative change, but there are no cellular proliferation and base- ment membrane thickening on light microscope, and diffuse foot process fusion on electro microscope. In immunohistochemical analysis, the infiltrating cells are mainly composed of T lymphocytes especially T-helper cell. All clinical and biochemical abnormalities of the patient resolved within two months after cessation of drug administration. These findings emphasize that renal function must be assessed with caution in patients taking drugs which inhibit prostaglandin synthesis. |
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