Acute interstitial nephritis due to proton pump inhibitors
A 22-year-old male was admitted with history of oliguria and back pain of 1-week duration. He had received pantoprazole and paracetamol for 10 days as treatment for dyspepsia and body ache. On examination, there was no fever, BP was 140/80 mm Hg, blood urea was 123 mg/dl, and serum creatinine 10.7 mg/dl. Hemodialysis was started. Renal biopsy showed AIN with lymphocytic and eosinophilic infiltrations in the interstitium with normal appearing glomeruli. PPI was stopped and he was started on pulse methyl prednisolone for 3 days followed by oral prednisolone for 12 weeks. His renal function normalized after 8 weeks and remained at 0.9 mg /dl after 12 months.