Acute granulomatous interstitial nephritis secondary to bisphosphonate alendronate sodium

Lourdes Peña De La Vega, Fernando C. Fervenza, Donna Lager, Thomas Habermann, Nelson Leung

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world and is characterized by a progressive accumulation of functionally incompetent monoclonal lymphocytes. Renal involvement has been described in CLL but is uncommon. Granulomatous interstitial nephritis is a rare but characteristic hallmark of certain diseases such as sarcoidosis and tuberculosis. These epithelial reactions have also been reported with medications, infections, inflammation, Wegener's granulomatosis, and jejunoileal bypass. We present a 74-year-old woman with a stage 0 chronic lymphocytic leukemia who developed acute renal failure following the initiation of alendronate. The renal biopsy revealed an acute granulomatous interstitial nephritis. Infectious and inflammatory etiologies were ruled out. Hemodialysis was required despite discontinuation of all medications. Partial recovery of renal function occurred after 6 weeks of prednisone therapy and cyclophosphamide. This report describes a unique case of acute granulomatous interstitial nephritis and leukemic cell kidney infiltration by CLL.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalRenal Failure
Volume27
Issue number4
DOIs
StatePublished - Jul 27 2005

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Keywords

  • Acute renal failure
  • Alendronate
  • Bisphosphonates
  • CLL
  • Chronic lymphocytic leukemia
  • Granulomatous interstitial nephritis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nephrology

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