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NDT Advance Access published online on July 24, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn423
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Acute interstitial nephritis due to deferasirox: a case report

Godela Brosnahan1,2, Neriman Gokden3 and Sundararaman Swaminathan1

1 Division of Nephrology, Department of Internal Medicine, University of Arkansas for Medical Sciences 2 Central Arkansas Veterans Healthcare System 3 Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Correspondence and offprint requests to: Godela Brosnahan, Division of Nephrology, University of Arkansas for Medical Sciences, 4301 W Markham, Slot 501, Little Rock, AR 72205, USA. Tel: +1-501-257-5831; Fax: +1-501-257-5827; E-mail: gbrosnahan{at}uams.edu



  Abstract

Deferasirox is a new oral iron chelator used to treat transfusional iron overload. Pre-marketing clinical trials revealed little organ-specific toxicity. Increases in serum creatinine were noted in one-third of patients but were mild and non-progressive. We describe a 62-year-old man with myelodysplastic syndrome who developed a progressive decline in renal function after starting deferasirox. A kidney biopsy showed acute interstitial nephritis with increased eosinophils, suggesting drug hypersensitivity. Deferasirox was discontinued and renal function returned to baseline. This is the first pathological description of deferasirox-related acute kidney injury in humans, which differs from tubular vacuolization observed in animals.

Keywords: acute interstitial nephritis; deferasirox; iron chelation

Received for publication: 6. 6.08
Accepted in revised form: 3. 7.08


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