Renal papillary necrosis due to ibuprofen

✍ Scribed by Gaurang M. Shah; Khalid K.Muhalwas; Robert L. Wibner

• Publisher: John Wiley and Sons
• Year: 1981
• Tongue: English
• Weight: 213 KB
• Volume: 24
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780240917

✦ Synopsis

Ibuprofen is a nonsteroidal antiinflammatory agent that is used to treat a variety of rheumatologic disorders (1). It is generally considered safe, and longterm studies indicate a lack of serious adverse effects (2). We report here a patient who developed renal papillary necrosis during treatment with ibuprofen.

Case Report. A 70-year-old white man was admitted to the Long Beach Veterans Administration Medical Center for evaluation of gross hematuria. Three months prior to admission he had mild upper respiratory symptoms with arthralgias and was treated by his private physician with ibuprofen, 400 mg 4 times per day. Three weeks after initiation of therapy he developed gross hematuria without other urinary or systemic symptoms. He was seen by a urologist, and cystoscopic examination revealed blood coming from the right ureter. After 3 weeks of therapy, ibuprofen was discontinued and the patient was subsequently referred to our institution. There was no history of diabetes mellitus, urinary tract infection, chronic alcohol abuse, or analgesic ingestion.

On admission, blood pressure was 120/80 mm Hg; the ocular fundi were normal and there was no skin rash, costovertebral angle tenderness, stigmata of chronic liver disease, or joint abnormalities. Results of