Antiepileptic drug-induced severe granulomatous interstitial nephritis.

Sunita Aggarwal, Chetan Garg, Shanu Kumar, Ranvijay Singh

BMJ case reports 2023 Mar 14

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Granulomatous interstitial nephritis (GIN) is a type of tubulointerstitial nephritis characterised by tubulointerstitial infiltration of mononuclear cells and eosinophils. It accounts for about 6% of all tubulointerstitial nephritis and is detected in ∼0.5%-0.9% of all renal biopsies. GIN has been linked to several antibiotics, non steroidal anti-inflammatory drugs (NSAIDs), and granulomatous disorders like tuberculosis and sarcoidosis but is rarely reported with anti-epileptic medications like phenytoin and levetiracetam. We present a case report of a man in his early 20's with previously normal renal function who developed GIN following levetiracetam and phenytoin consumption for 7 years. After withdrawal of the causative drug and starting steroid therapy, his kidney function gradually improved. In cases of GIN, medication history is important in the evaluation of aetiology. © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Sunita Aggarwal, Chetan Garg, Shanu Kumar, Ranvijay Singh. Antiepileptic drug-induced severe granulomatous interstitial nephritis. BMJ case reports. 2023 Mar 14;16(3)