Pantoprazole-Induced Acute Interstitial Nephritis: A Case Report

Abstract

Introduction: Proton pump inhibitors (PPIs), such as pantoprazole, are widely prescribed for managing acid-related gastrointestinal disorders due to their efficacy and safety. However, despite their generally favorable profile, PPIs have been associated with rare but serious adverse effects, including Acute Interstitial Nephritis (AIN). AIN is an immune-mediated condition that can lead to significant renal dysfunction if not promptly recognized and treated.

Case Details: We present the case of a 73-year-old male with a history of ischemic heart disease, who developed AIN following a brief course of intravenous and oral pantoprazole. The patient presented with shortness of breath, bilateral leg swelling, and worsening renal function. Laboratory investigations revealed a marked increase in serum creatinine, and urine analysis showed proteinuria and hematuria. Abdominal ultrasound indicated bilateral grade 1 renal parenchymal disease. Following the cessation of pantoprazole and the initiation of corticosteroid therapy, the patient’s renal function improved, confirming the diagnosis of pantoprazole-induced AIN.

Conclusion: This case highlights the need for heightened clinical awareness of PPI-induced AIN, particularly in elderly patients with recent PPI use. Although rare, this adverse drug reaction can lead to significant renal impairment if not promptly recognized and managed. Clinicians should consider AIN in the differential diagnosis of acute kidney injury in patients on PPIs to prevent irreversible damage.