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2018 ; 5
(1
): 16
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gab.com Text
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Cefazolin-Related Acute Interstitial Nephritis with Associated Nephrotic-Range
Proteinuria: A Case Report
#MMPMID29633042
Xu A
; Hyman D
; Lu LB
Drug Saf Case Rep
2018[Apr]; 5
(1
): 16
PMID29633042
show ga
A 67-year-old male with history of well controlled type 2 diabetes mellitus and
hypertension developed acute interstitial nephritis (AIN) with nephrotic-range
proteinuria during treatment with cefazolin for methicillin-sensitive
Staphylococcus aureus and Group B Streptococcus (GBS) bacteremia. The patient
received intravenous cefazolin 2 g every 8 h for 4 weeks prior to presentation to
the emergency department with abdominal distension, nausea, and vomiting.
Investigations revealed a serum ascites albumin gradient of 1.0 with total
protein of 1.8 g/dL suggestive of nephrotic syndrome, which was confirmed with a
spot urine protein/creatinine ratio that estimated 7.95 g of protein per day.
Serum creatinine was elevated compared with baseline. Urine studies showed
sterile pyuria with 3+?protein and eosinophiluria. The patient was diagnosed with
AIN with nephrotic-range proteinuria associated with cefazolin use. Cefazolin was
discontinued and, within a couple of days, the patient's creatinine stabilized.
He was discharged with prednisone 60 mg once a day for 10 days with a taper over
2 weeks for his AIN. The patient's creatinine and proteinuria slowly decreased
over the next couple of weeks, however, did not recover to baseline. A Naranjo
assessment score of 6 was obtained, indicating a probable relationship between
the patient's AIN with nephrotic-range proteinuria and his use of cefazolin.