Reversible cause of renal failure in a 16-year-old allograft

• Main Authors: Navin Pattanashetti, Ritambhra Nada, Krishan Lal Gupta, Raja Ramachandran
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Indian Journal of Transplantation
• Subjects: Granulomatous interstitial nephritis; proton-pump inhibitor; renal transplant
• Online Access: http://www.ijtonline.in/article.asp?issn=2212-0017;year=2019;volume=13;issue=1;spage=50;epage=51;aulast=Pattanashetti

Granulomatous interstitial nephritis (GIN) is reported in 0.9% of the native renal biopsies. GIN occurrence in renal allograft is rare and a proton-pump inhibitor-induced GIN is infrequent. Our patient, a 36-year-old renal transplant recipient (2002), on triple immunosuppression with normal renal function, after 16 years of renal transplant, presented with raised serum creatinine (1.9 mg/dl), biopsy revealed GIN, workup for secondary causes were negative, on detailed inquiry, the patient was receiving pantoprazole for the last 1 month on the prescription of his primary physician for dyspeptic symptoms. On stopping pantoprazole, serum creatinine reduced to baseline (1 mg/dl) at 15 days, confirming the diagnosis of pantoprazole-induced GIN.