• Internal medicine · Oct 2024

    Case Reports

    Severe acute interstitial nephritis induced by α-glucosidase inhibitor miglitol in an elderly patient with type 2 diabetic nephropathy.

    • Kazutoshi Ono, Takahiro Masuda, Yuko Ono, Erika Hishida, Hiromichi Yoshizawa, Toshimi Imai, Hiroshi Satonaka, Tetsu Akimoto, and Daisuke Nagata.
    • Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
    • Intern. Med. 2024 Oct 15; 63 (20): 282728312827-2831.

    AbstractA 79-year-old male patient with type 2 diabetic nephropathy and hypertension was admitted to our hospital because of acute kidney injury with significantly elevated serum creatinine (8.12 mg/dL) and urinary β2-microglobulin (β2MG, 31,748 μg/L) levels. α-glucosidase inhibitor (α-GI) miglitol, started two weeks prior to presentation, was discontinued because drug-induced acute interstitial nephritis (AIN) was suspected. Renal biopsy revealed AIN and diabetic nephropathy. The drug-induced lymphocyte stimulation test for miglitol was also positive. After the discontinuation of miglitol, the urinary β2MG levels decreased to the normal range. This case raises the possibility that α-GI miglitol can worsen the renal function in patients with underlying renal dysfunction.

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