MINIMAL CHANGE DISEASE AND ACUTE TUBULAR NECROSIS CAUSED BY DICLOFENAC

摘要: Renal side-effects of anti-inflammatory drugs (NSAID) can be diveded in five clinical syndromes: acute renal failure, intersticial nephritis with nephrotic syndrome, electrolyte and fluid disorders, hypertension analgetic nephropathy.We described one unusual combination tubular necrosis (ATN) minimal change disease (MCD). Reports ATN MCD syndrome caused by NSAID exposure are very rare. This is the first reported case associated Diclofenac. A 53-year-old woman failure (creatinine was 716 μ mol/L) (she generalizied oedema protein excretion 6.0g/day) admitted to our hospital. She also had eosinophilia. Her medical history unremarkable except for nontreated years. Only medication she has been taking Diclofenac chronic muscular pain knee arthropathy. exert their toxic effect on kidney ihibition prostaglandin synthesis causing an allergic interstitial nephritis. The pathogenesis NSAID-associated unclear. cause inhibiton cyclooxigenase shift arachidonic acid toward lipooxygenase pathway, which may result enhanced production proinflammatory leukotriens. In addition, lypooxigenase products increase vascular permeability contribute altering glomerular-cappilary barrier. patient treated steroides. response excellent remission normalization excretory function within 6 weeks.