IMMUNOALLERGIC GRANULOMATOUS INTERSTITIAL NEPHRITIS FOLLOWING TREATMENT WITH OMEPRAZOLE

A 69-year-old male who had a long history of ocular myasthenia was tre ated with omeprazole for 3 months. Progressive renal insufficiency was discovered fortuitously. There were no clinical or laboratory manifes tations of immunoallergy, Renal biopsy revealed severe granulomatous i nterstitial nephritis, tubular injury and fibrosis. Histology of a liv er nodule disclosed hepatic granulomatous involvement. Withdrawal of o meprazole and a short course of corticosteroids were followed by impro vement but not normalization of renal function. This is the eighth rep ort of omeprazole-induced interstitial nephritis. In the present case as in 2 others in the literature, the patients had been followed up fo r an autoimmune disease previously, which suggests that in patients wi th such a background, patients should be examined regularly for renal functional impairment during treatment with omeprazole.