Cephotaxime-associated allergic interstitial nephritis and MPO-ANCA positive vasculitis

We report a case of reversible acute renal failure after cephotaxime treatm ent in a patient affected by non-Hodgkin lymphoma. Renal biopsy showed necr otizing vasculitis associated with eosinophil-rich interstitial inflammator y infiltrates and patchy infiltrates of CD20 + lymphoid cells. High serum p -ANCA titers were also detected. Drug withdrawal was closely related with r ecovery of renal function and disappearance of ANCA. Acute renal failure th erefore represented a consequence of ANCA-mediated renal vasculitis and acu te interstitial nephritis related to cephotaxime treatment.