Acute tubular necrosis as a part of vancomycin induced drug rash with eosinophilia and systemic symptoms syndrome with coincident postinfectious glomerulonephritis.
10.3345/kjp.2016.59.3.145
- Author:
Kyung Min KIM
1
;
Kyoung SUNG
;
Hea Koung YANG
;
Seong Heon KIM
;
Hye Young KIM
;
Gil Ho BAN
;
Su Eun PARK
;
Hyoung Doo LEE
;
Su Young KIM
Author Information
1. Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea. suyung@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
DRESS syndrome;
Acute kidney injury;
Acute kidney tubular necrosis;
Postinfectious glomerulonephritis;
Vancomycin
- MeSH:
Acute Kidney Injury;
Allopurinol;
Biopsy;
Busan;
Carbamazepine;
Ceftriaxone;
Child;
Drug Hypersensitivity Syndrome;
Edema;
Eosinophilia*;
Exanthema*;
Fever;
Glomerulonephritis*;
Humans;
Kidney Tubular Necrosis, Acute;
Lymphatic Diseases;
Male;
Necrosis*;
Nephritis, Interstitial;
Proteinuria;
Sulfasalazine;
Vancomycin*
- From:Korean Journal of Pediatrics
2016;59(3):145-148
- CountryRepublic of Korea
- Language:English
-
Abstract:
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.
