Acute kidney injury in a girl with ulcerative colitis and cytomegalovirus-induced focal segmental glomerular sclerosis
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- Chirumamilla, S.R., He, C., Racusen, L.C. et al. World J Pediatr (2013) 9: 84. doi:10.1007/s12519-011-0302-8
Mesalamine or 5-aminosalicylic acid (5-ASA) has proven efficacy in treating patients with ulcerative colitis (UC). Although mesalamine is considered safe, it has been associated with acute interstitial nephritis and renal failure.
Herein we present a case of a child with UC who developed acute renal failure on mesalamine therapy.
A 15-year-old African-American girl with well-controlled UC presented to the Johns Hopkins Hospital with a four-day history of high fever, malaise, generalized body aches, and productive non-bloody cough. Over the next three days, she developed acute renal failure with fluid retention, and elevated serum creatinine and blood urea nitrogen. A kidney biopsy showed drug induced acute interstitial nephritis and focal segmental glomerulosclerosis with viral inclusion bodies likely secondary to cytomegalovirus.
When treating UC patients with a history of underlying renal disease, it is advised to carefully monitor renal function while on mesalamine therapy.