Drug-related tubulo-interstitial nephritis

Case
A 54-year-old woman, Jenny, presented to her GP with a 7-10-day history of worsening malaise, dry mouth, polydipsia, polyuria and vomiting, as well as deteriorating symptoms of depression and paranoia.

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Although Jenny was clinically dehydrated, her physical examination was otherwise unremarkable.

Blood tests revealed a normochromic normocytic anaemia (haemoglobin 98g/L [reference range, 115-160g/L]) and an acute kidney injury (creatinine 482μmol/L [50-90μmol/L]); on routine testing eight months earlier, Jenny’s serum creatinine level had been 80μmol/L.

Jenny’s GP

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