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Biopsy-proven vancomycin-associated interstitial nephritis and acute tubular necrosis

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Abstract

Fewer than ten biopsy-proven case reports exist on vancomycin-associated interstitial nephritis (VAIN) and vancomycin-associated acute tubular necrosis (VAATN). Among these, several are confounded by the use of other potentially offending drugs. We report a case of isolated VAIN/VAATN in a patient on no other potentially nephrotoxic agents other than vancomycin. The patient received intravenous vancomycin for coagulase-negative staphylococcus bacteremia. Her baseline serum creatinine of 0.9 mg/dL increased to 9.6 mg/dL after 1 week of therapy during which vancomycin levels peaked at 141 μg/mL. Renal biopsy revealed acute interstitial nephritis with lymphocytic and eosinophilic infiltrate and acute tubular necrosis. Upon discontinuation of vancomycin and administration of prednisone complete renal recovery ensued over a period of 4 weeks.

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Authors and Affiliations

  1. Lankenau Medical Center, 100 E Lancaster Ave, Lankenau Medical Office Building West, Suite 130, Wynnewood, PA, 19096, USA

    Naing Lin Htike & Geoffrey Teehan

  2. 1 Cooper Plaza, Cooper University Hospital, Camden, NJ, 08103, USA

    I. Bruce Elfenbein

  3. Lankenau Medical Center, 100 E Lancaster Ave, Lankenau Medical Office Building East, Suite 164, Wynnewood, PA, 19096, USA

    Jerome Santoro & Brett Gilbert

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  1. Naing Lin Htike
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  2. Jerome Santoro
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  3. Brett Gilbert
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  4. I. Bruce Elfenbein
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  5. Geoffrey Teehan
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Correspondence to Naing Lin Htike.

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Htike, N.L., Santoro, J., Gilbert, B. et al. Biopsy-proven vancomycin-associated interstitial nephritis and acute tubular necrosis. Clin Exp Nephrol 16, 320–324 (2012). https://doi.org/10.1007/s10157-011-0559-1

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  • DOI: https://doi.org/10.1007/s10157-011-0559-1

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