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Case Report
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Korean J Med. 2014;87(3):352-356. Published online September 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.3.352
- 에탐부톨에 의한 급성 신질환 1예
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홍창우1, 노신영1, 이인희1, 안기성1, 박관규2, 강건우1
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1대구가톨릭대학교 의과대학 내과학교실
2대구가톨릭대학교 의과대학 병리학교실
- A Case of Acute Kidney Injury in a Patient with Pulmonary Tuberculosis Receiving Ethambutol Therapy
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Chang Woo Hong1, Sin Young Nho1, In Hee Lee1, Ki Sung Ahn1, Kwan Kyu Park2, Gun Woo Kang1
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1Departments of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
2Departments of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea
- Corresponding author: Gun Woo Kang ,Tel: +82-53-650-4775, Fax: +82-53-650-4570, Email: gwkang4540@hanmail.net
- Received: December 17, 2013; Revised: January 6, 2014 Accepted: January 21, 2014.
- 항결핵제 사용 후 발생한 급성 신질환은 리팜핀에 의한 부작용이 원인일 수 있으나 매우 드물게 에탐부톨에 의해서도 유발될 수 있다. 이에 저자 등은 고용량의 에탐부톨 복용과 관련된 직접적인 세포독성으로 유발된 급성 사이질콩팥염에 의한 급성 신질환으로 진단하였고 에탐부톨 사용을 중지하고 대증요법 시행만으로 신기능이 호전된 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.
߽ɾ :에탐부톨; 사이질콩팥염; 급성 신질환
- Abstract
- Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved.
Keywords :Ethambutol, Interstitial nephritis, Acute kidney injury
