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(Chest. 1998;114:1220-1223.)
© 1998 American College of Chest Physicians

Tubulointerstitial Nephritis Induced by the Leukotriene Receptor Antagonist Pranlukast

Scott J. Schurman MD1; Janice M. Alderman PharmD2; Marc Massanari PharmD, FCCP2; Atilano G. Lacson MD3; and Sharon A. Perlman MD1

1 From the Division of Nephrology, Department of Pediatrics, University of South Florida and All Children's Hospital, St. Petersburg, FL
2 From the Children's Research Institute, All Children's Hospital, St. Petersburg, FL.
3 From the Department of Pathology, All Children's Hospital, St. Petersburg, FL.

Scott J. Schurman, MD, All Children's Hospital, 801 Sixth St., South, St. Petersburg, FL 33701. E-mail: schurman{at}allkids.org

A 7-year-old boy with asthma was receiving the leukotriene receptor antagonist pranlukast (Ultair; SmithKline Beecham; Pittsburgh) as part of an open-label clinical trial. The patient's asthma improved, and he remained asymptomatic; but routine study evaluations 9 to 12 months into therapy showed microhematuria, proteinuria, glucosuria, anemia, and renal insufficiency. Renal biopsy demonstrated changes classic for acute allergic tubulointerstitial nephritis (ATIN), with mixed interstitial inflammatory infiltrate including eosinophils. Within 6 months of pranlukast withdrawal, anemia resolved and urinary sediment and renal function normalized. The case demonstrates that hypersensitivity reaction to pranlukast and resultant ATIN is possible, and that periodic urine testing in patients receiving pranlukast should be considered.

Key Words: drug-induced acute tubulointerstitial nephritis • eosinophils • leukotriene receptor antagonist • renal insufficiency

Submitted on June 9, 1998
Accepted on June 25, 1998






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Copyright © 1998 by the American College of Chest Physicians.