Acute interstitial nephritis and nephrogenic diabetes insipidus following treatment with sulfamethoxazole-trimethoprim and temozolomide

Akshay Athavale; Jack Morris; Meg Jardine; Martin Gallagher; Shaundeep Sen; Angus Ritchie; Amanda Y Wang

doi:10.1111/nep.13783

Acute interstitial nephritis and nephrogenic diabetes insipidus following treatment with sulfamethoxazole-trimethoprim and temozolomide

Nephrology (Carlton). 2021 Jan;26(1):12-14. doi: 10.1111/nep.13783. Epub 2020 Oct 5.

Authors

Akshay Athavale^{1

2}, Jack Morris³, Meg Jardine^{1

2

4}, Martin Gallagher^{1

2

4}, Shaundeep Sen^{1

2}, Angus Ritchie^{1

2}, Amanda Y Wang^{1

2

4}

Affiliations

¹ Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
² Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
³ Department of Endocrinology and Metabolism, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
⁴ Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.

PMID: 32935422
DOI: 10.1111/nep.13783

Abstract

We report a case of acute interstitial nephritis with associated nephrogenic diabetes insipidus in a patient treated with temozolomide and sulfamethoxazole-trimethoprim for glioblastoma multiforme. Kidney biopsy demonstrated focal tubulointerstitial change with tubular dilatation, epithelial change and interstitial inflammation. The patient's kidney function improved with cessation of sulfamethoxazole-trimethoprim and treatment with hydrochlorothiazide for nephrogenic diabetes insipidus. Recommencement of temozolomide did not result in further deterioration in kidney function. In this case report, we discuss the novel association between sulfamethoxazole-trimethoprim-induced acute interstitial nephritis and nephrogenic diabetes insipidus, and suggest possible mechanisms involved.

Keywords: acute interstitial nephritis; acute kidney injury; diabetes insipidus; drug induced; sulfamethoxazole; trimethoprim.

Publication types

Case Reports

MeSH terms

Acute Kidney Injury* / chemically induced
Acute Kidney Injury* / diagnosis
Acute Kidney Injury* / physiopathology
Acute Kidney Injury* / therapy
Anti-Bacterial Agents / administration & dosage
Anti-Bacterial Agents / adverse effects
Antineoplastic Agents, Alkylating / administration & dosage
Antineoplastic Agents, Alkylating / adverse effects
Brain Neoplasms / drug therapy*
Brain Neoplasms / pathology
Diabetes Insipidus, Nephrogenic / diagnosis
Diabetes Insipidus, Nephrogenic / drug therapy
Diabetes Insipidus, Nephrogenic / etiology
Diabetes Insipidus, Nephrogenic / physiopathology
Glioblastoma / drug therapy*
Glioblastoma / pathology
Humans
Hydrochlorothiazide / administration & dosage*
Kidney Function Tests
Male
Middle Aged
Nephritis, Interstitial* / chemically induced
Nephritis, Interstitial* / diagnosis
Nephritis, Interstitial* / physiopathology
Nephritis, Interstitial* / therapy
Sodium Chloride Symporter Inhibitors / administration & dosage
Temozolomide / administration & dosage
Temozolomide / adverse effects
Treatment Outcome
Trimethoprim, Sulfamethoxazole Drug Combination* / administration & dosage
Trimethoprim, Sulfamethoxazole Drug Combination* / adverse effects

Substances

Anti-Bacterial Agents
Antineoplastic Agents, Alkylating
Sodium Chloride Symporter Inhibitors
Hydrochlorothiazide
Trimethoprim, Sulfamethoxazole Drug Combination
Temozolomide