Display options
Cite
Sirvent AE, Enríquez R, Muci T, et al. Acute tubulointerstitial nephritis and polyclonal hypergammaglobulinaemia: Which is the culprit?. Clin Pract. 2018;8(4):1065doi: 10.4081/cp.2018.1065.
Sirvent, A. E., Enríquez, R., Muci, T., Ibañez, F. J. A., Millán, I., Almiñana, A., Ruiz-Ferrús, R., & Del Cerro, L. J. (2018). Acute tubulointerstitial nephritis and polyclonal hypergammaglobulinaemia: Which is the culprit?. Clinics and practice, 8(4), 1065. https://doi.org/10.4081/cp.2018.1065
Sirvent, Ana E, et al. "Acute tubulointerstitial nephritis and polyclonal hypergammaglobulinaemia: Which is the culprit?." Clinics and practice vol. 8,4 (2018): 1065. doi: https://doi.org/10.4081/cp.2018.1065
Sirvent AE, Enríquez R, Muci T, Ibañez FJA, Millán I, Almiñana A, Ruiz-Ferrús R, Del Cerro LJ. Acute tubulointerstitial nephritis and polyclonal hypergammaglobulinaemia: Which is the culprit?. Clin Pract. 2018 Nov 07;8(4):1065. doi: 10.4081/cp.2018.1065. eCollection 2018 Oct 26. PMID: 30581545; PMCID: PMC6275461.
Copy Download .nbib Format: NLM
Share it on

Clin Pract. 2018 Nov 07;8(4):1065. doi: 10.4081/cp.2018.1065. eCollection 2018 Oct 26.

Acute tubulointerstitial nephritis and polyclonal hypergammaglobulinaemia: Which is the culprit?.

Clinics and practice

Ana E Sirvent, Ricardo Enríquez, Tania Muci, Francisco Javier Ardoy- Ibañez, Isabel Millán, Amadeo Almiñana, Rosalía Ruiz-Ferrús, Luis Jiménez Del Cerro

Affiliations

  1. Nephrology Section.
  2. Pathology Section.
  3. Diagnostic Radiology Service.
  4. Ophthalmology Section, Hospital General Universitario de Elche, Spain.

PMID: 30581545 PMCID: PMC6275461 DOI: 10.4081/cp.2018.1065

Abstract

Proton pump inhibitors (PPIs) are among the most frequent implicated drugs in acute tubulointerstitial nephritis (ATIN), nevertheless it is important to report cases with atypical profiles. A 80-year-old female, exposed during 34 months to omeprazole, presented with polyclonal hypergammaglobulinaemia and renal failure. After stopping omeprazole there was a partial improvement in serum creatinine and IgG. Renal biopsy revealed ATIN; immunohistochemistry for IgG4 was negative. Treatment with steroids and mycophenolate sodium improved renal function and normalized immunoglobulins. The lack of data of other entities and the patient's evolution strongly point omeprazole as the culprit. After 27 months of follow-up, she remains clinical and analytically stable. ATIN caused by PPIs may appear after a long period of exposure and may be accompanied by analytical anomalies that simulate a systemic disease.

Keywords: Acute tubulointerstitial nephritis; Hypergammaglobulinaemia; Omeprazole; Renal failure

Conflict of interest statement

Conflict of interest: the authors declare no potential conflict of interest.

References

  1. Surv Ophthalmol. 2001 Nov-Dec;46(3):195-208 - PubMed
  2. N Engl J Med. 2003 Nov 20;349(21):2055-63 - PubMed
  3. Nephrol Dial Transplant. 2004 Jun;19(6):1441-6 - PubMed
  4. Clin Gastroenterol Hepatol. 2006 May;4(5):597-604 - PubMed
  5. Nephrology (Carlton). 2006 Oct;11(5):381-5 - PubMed
  6. Br J Clin Pharmacol. 2010 May;69(5):516-9 - PubMed
  7. Pediatr Nephrol. 2011 Feb;26(2):291-9 - PubMed
  8. Mod Pathol. 2012 Aug;25(8):1086-97 - PubMed
  9. Clin J Am Soc Nephrol. 2014 Jan;9(1):21-8 - PubMed
  10. Nephrology (Carlton). 2014 Jun;19(6):359-65 - PubMed
  11. Am J Kidney Dis. 2014 Oct;64(4):558-66 - PubMed
  12. Nephrol Dial Transplant. 2015 Sep;30(9):1472-9 - PubMed
  13. Diagn Pathol. 2015 Jul 01;10:83 - PubMed
  14. J Nephrol. 2016 Oct;29(5):611-6 - PubMed
  15. Clin Nephrol. 1994 Oct;42(4):280 - PubMed
  16. Clin Nephrol. 1995 Aug;44(2):129 - PubMed

Publication Types