Abstract
Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved.
항결핵제 사용 후 발생한 급성 신질환은 리팜핀에 의한 부작용이 원인일 수 있으나 매우 드물게 에탐부톨에 의해서도 유발될 수 있다. 이에 저자 등은 고용량의 에탐부톨 복용과 관련된 직접적인 세포독성으로 유발된 급성 사이질콩팥염에 의한 급성 신질환으로 진단하였고 에탐부톨 사용을 중지하고 대증요법 시행만으로 신기능이 호전된 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.
