The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of minimal change glomerulopathy without interstitial nephritis induced by non-opiate analgesics

비마약성 진통제 복용 후 간질성 신염없이 발생된 미세변화 신증후군 1예

Li, Jae-Hoon;Shim, Hyeok;Yeom, Joo-Jin;Lee, Myeung-Su;Park, Byoung-Hyun;Oh, Seok-Kyu;Kim, Nam-Ho;Park, Moo-Rim;Ahn, Seon-Ho;Song, Ju-Hung
이재훈;심혁;염주진;이명수;박병현;오석규;김남호;박무림;안선호;송주흥

  • Published : 20020000
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Abstract

The use of nonsteroidal antiinflammatory drugs (NSAIDs) can be complicated by severe forms of renal dysfunction. These include fluid and electrolyte abnormalities, acute renal insufficiency due to alteration in renal hemodynamics, or interstitial nephritis and proteinuria secondary to glomerular pathology, which has the histologic characteristics of minimal change glomerulopathy (MCG). While NSAID-induced nephrotic syndrome characteristically consists of MCG with interstitial nephritis, which is the most common clinical manifestation, it rarely consists of MCG without interstitial nephritis, which has been reported in a handful of patients who took fenoprofen, ibuprofen, sulindac, diclofenac, or zomepirac. We experienced a 66-year-old female patient who presented with low serum albumin, proteinuria and generalized edema and received $Geworin^{\circledR}$ for about 2 year before developing symptoms. She histologically had MCG without interstitial nephritis and achieved a complete remission thirty-fifth days after discontinuing the drug. A cause-and-effect relationship of this disease to $Geworin^{\circledR}$ administration is strongly suggested by the resolution of the proteinuria after the drug was stopped and by no evidence of any impairment in renal function after twenty eight months of follow-up.

현재 isopropylantipyrine을 함유하고 있는 혼합약물에서 acetaminophen의 효과만 강조되고 있고 있지만 isopropylantipyrine도 다른 NSAID와 동일한 기전으로 프로스그란딘 합성을 억제하여 신 부작용을 초래할 수 있다. 또한 NSAID 약물에 의한 미세변화 신증후군은 대부분 간질성 신염을 동반하는데, 간질성 신염없이 미세변화 신증후군만 발생하는 경우는 드물게 보고되고 있다. 저자들은 acetaminophen과 isopropylantipyrine의 혼합물인 $Geworin^{\circledR}$을 장기간 복용한 환자에서 간질성 신염없이 미세변화 신증후군을 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

References

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