Drug-induced Interstitial Nephritis in a Patient with Ulcerative Colitis Treated with 5-Aminosalicylic Acid

Intern Med. 2024 Apr 15;63(8):1081-1085. doi: 10.2169/internalmedicine.2366-23. Epub 2023 Sep 1.

Abstract

This report describes the case of a 76-year-old man with ulcerative colitis who developed interstitial nephritis after starting 5-Aminosalicylic acid (5-ASA) therapy. The patient experienced an initial improvement in symptoms, but developed fatigue, anorexia, and severe renal dysfunction 2.5 months later. Renal biopsy confirmed drug-induced interstitial nephritis, and conservative treatment with fluid replacement and the discontinuation of 5-ASA improved the patient's condition. Clinicians should monitor patients receiving 5-ASA therapy for potential adverse effects, particularly renal injury, and promptly investigate symptoms of renal dysfunction. Early recognition and discontinuation of the offending agent may prevent further damage and improve patient outcomes.

Keywords: 5-Aminosalicylic acid; acute renal failure; drug-induced renal injury.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Colitis, Ulcerative* / drug therapy
  • Colitis, Ulcerative* / pathology
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Kidney / pathology
  • Male
  • Mesalamine / adverse effects
  • Nephritis, Interstitial* / chemically induced
  • Nephritis, Interstitial* / diagnosis
  • Nephritis, Interstitial* / pathology
  • Renal Insufficiency* / pathology

Substances

  • Mesalamine
  • Anti-Inflammatory Agents, Non-Steroidal