Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome.
dc.contributor.author | Garvey, J P | |
dc.contributor.author | Brown, C M | |
dc.contributor.author | Chotirmall, S H | |
dc.contributor.author | Dorman, A M | |
dc.contributor.author | Conlon, P J | |
dc.contributor.author | Walshe, J J | |
dc.date.accessioned | 2011-04-05T14:44:59Z | |
dc.date.available | 2011-04-05T14:44:59Z | |
dc.date.issued | 2009-11 | |
dc.identifier.citation | Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome. 2009, 72 (5):331-6 Clin. Nephrol. | en |
dc.identifier.issn | 0301-0430 | |
dc.identifier.pmid | 19863874 | |
dc.identifier.uri | http://hdl.handle.net/10147/127236 | |
dc.description.abstract | Acute interstitial nephritis (AIN) secondary to trimethoprim-sulfamethoxazole (TMP-SMX) is well documented as a cause of acute renal failure in native kidneys. TMP-SMX is the standard prophylactic agent against pneumocystis carinii (PCP) used in the early post-transplant period, however, it has to date only been indirectly associated with AIN in renal allografts. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We describe eleven renal transplant patients with acute allograft dysfunction in whom a transplant biopsy demonstrated primary histopathologic features of allergic AIN, all of whom were receiving TMP-SMX in addition to other medications known to cause AIN. | |
dc.description.abstract | All cases occurred within 1 month of transplantation and accounted for 2.12% (11/518) of the total number of transplant biopsies performed during the study period. However, this figure increased to 10.1% (11/109) when those biopsies performed for early allograft dysfunction (< 1 month) were taken into account. After discontinuation of TMP- SMX alone, all patients had an immediate improvement in serum creatinine with excellent long term allograft function - mean improvement of serum creatinine from 465 micromol/l to 136 micromol/l at last follow-up (range 15 - 55 months). | |
dc.description.abstract | AIN secondary to TMP-SMX, although an uncommon cause of allograft dysfunction over the study period, accounted for over 10% of cases of allograft dysfunction within the first month of transplantation. Therefore, a high degree of clinical suspicion for TMP-SMX-induced AIN is warranted when confronted with early acute allograft dysfunction. | |
dc.language.iso | en | en |
dc.subject.mesh | Acute Disease | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Anti-Infective Agents | |
dc.subject.mesh | Creatinine | |
dc.subject.mesh | Female | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Immunosuppressive Agents | |
dc.subject.mesh | Kidney | |
dc.subject.mesh | Kidney Transplantation | |
dc.subject.mesh | Male | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Nephritis, Interstitial | |
dc.subject.mesh | Trimethoprim-Sulfamethoxazole Combination | |
dc.title | Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome. | en |
dc.type | Article | en |
dc.contributor.department | Department of Nephrology, Beaumont Hospital, Dublin, Ireland. | en |
dc.identifier.journal | Clinical nephrology | en |
dc.description.province | Leinster | |
html.description.abstract | Acute interstitial nephritis (AIN) secondary to trimethoprim-sulfamethoxazole (TMP-SMX) is well documented as a cause of acute renal failure in native kidneys. TMP-SMX is the standard prophylactic agent against pneumocystis carinii (PCP) used in the early post-transplant period, however, it has to date only been indirectly associated with AIN in renal allografts. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We describe eleven renal transplant patients with acute allograft dysfunction in whom a transplant biopsy demonstrated primary histopathologic features of allergic AIN, all of whom were receiving TMP-SMX in addition to other medications known to cause AIN. | |
html.description.abstract | All cases occurred within 1 month of transplantation and accounted for 2.12% (11/518) of the total number of transplant biopsies performed during the study period. However, this figure increased to 10.1% (11/109) when those biopsies performed for early allograft dysfunction (< 1 month) were taken into account. After discontinuation of TMP- SMX alone, all patients had an immediate improvement in serum creatinine with excellent long term allograft function - mean improvement of serum creatinine from 465 micromol/l to 136 micromol/l at last follow-up (range 15 - 55 months). | |
html.description.abstract | AIN secondary to TMP-SMX, although an uncommon cause of allograft dysfunction over the study period, accounted for over 10% of cases of allograft dysfunction within the first month of transplantation. Therefore, a high degree of clinical suspicion for TMP-SMX-induced AIN is warranted when confronted with early acute allograft dysfunction. |