WEGENERS GRANULOMATOSIS IN A PATIENT WITH APPARENT DRUG-INDUCED ACUTEINTERSTITIAL NEPHRITIS

We describe a patient whose clinical presentation was suggestive of dr ug-induced acute interstitial nephritis (AIN). A renal biopsy and sero logic testing led instead to the diagnosis of Wegener's granulomatosis (WG) with necrotizing crescentic glomerulonephritis. Treatment with c orticosteroids and cyclophosphamide resulted initially in complete rec overy of renal function, and an exacerbation of acute renal failure af ter doses of these agents had been tapered responded to resumption of the original regimen. We report this case to emphasize the potentially identical presentations of AIN and WG. Since the two conditions are t reated differently, we suggest that the diagnosis of AIN should be acc epted only after biopsy confirmation.