Kidney Biopsy Teaching Case
A Case of Cocaine-Induced Acute Interstitial Nephritis

https://doi.org/10.1053/j.ajkd.2008.03.018Get rights and content

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Clinical History

A 38-year-old African American man with no prior medical history presented to an outside hospital's emergency department with right upper-quadrant pain of 3 days' duration. The patient admitted to binging on alcohol and cocaine for 5 to 7 days before presentation, but stopped the day before he presented to the emergency department. One day before the emergency department visit, the patient took 2 doses of ibuprofen, 600 mg, for the pain. The patient additionally reported nausea and decreased

Discussion

When evaluating a patient with AKI, one must always be mindful that the cause may be multifactorial. Also, given the inherently complex nature of AKI, a systematic approach must be used. We attempted to work through the cause of this patient's AKI and will provide what we believe to be the most likely diagnosis.

The patient's recent cocaine use seemed a likely cause of AKI. The notion of AKI secondary to cocaine abuse is not a novel concept; 2 common causes are rhabdomyolysis and arterial

Acknowledgements

We thank Maristela L. Onozato, Georgetown University Hospital, for her assistance in obtaining the pathology images.

Support: None.

Financial Disclosure: None.

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Originally published online as doi:10.1053/j.ajkd.2008.03.018 on May 9, 2008.

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