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Acute interstitial nephritis with membranous nephropathy in bucillamine-treated
rheumatoid arthritis
#MMPMID28509179
Takamatsu N
; Takizawa H
; Sugawara H
; Ogawa Y
CEN Case Rep
2016[May]; 5
(1
): 103-107
PMID28509179
show ga
In bucillamine-treated patients, persistent proteinuria caused by membranous
nephropathy (MN) is a major adverse effect affecting the kidneys. We experienced
a case of acute interstitial nephritis (AIN) with MN caused by bucillamine. An
81-year-old Japanese woman with a past medical history of rheumatoid arthritis
and hypertension presented with a fever, epigastric pain, and nausea of 1 week's
duration. She had commenced bucillamine 4 months earlier. At the time of
admission, her baseline creatinine (0.8 mg/dl) had risen to 6.8 mg/dl. A renal
biopsy revealed AIN with concomitant MN. Renal function gradually improved after
bucillamine administration was stopped. In addition to MN, bucillamine can cause
AIN, which requires a renal biopsy for definitive diagnosis. Given the host of
pathological findings that tend to develop in patients using bucillamine,
patients receiving the drug who present with symptoms of acute kidney injury
should undergo a renal biopsy to determine the presence of AIN.
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