Effect of corticosteroids during ongoing drug exposure in pantoprazole-induced interstitial nephritis

Acute interstitial nephritis (AIN) represents a significant cause of acute renal failure in hospital practice. An increasing number of drugs are known to cause AIN. Due to the lack of prospective, randomized clinical trials, the most effective management is still uncertain, especially the role of steroids in the resolution of interstitial nephritis remains to be further defined. We report on a case with pantoprazole-induced interstitial nephritis and on the effect of steroids during ongoing drug exposure. In spite of ongoing drug exposure, steroids led to almost complete resolution of the inflammatory infiltrates. Early diagnosis of interstitial nephritis by renal biopsy and identification of the causative drug and its withdrawal remains the mainstay of treatment. However, the additional use of steroids has the potential to eradicate inflammatory infiltrates more rapidly and completely and may thus be important to minimize subsequent chronic damage.