CHRONIC PHENACETIN NEPHROPATHY

SUMMARY Five cases of papillary necrosis are presented, four giving a history of prolonged excessive consumption of phenacetin—containing analgesic mixtures (chronic phenacetin nephropathy), the fifth in association with gout. The distribution and significance of the renal parenchymal contraction in chronic phenacetin nephropathy is discussed in relation to the medullary necrosis. It is suggested that such contraction is not due to a ”primary chronic interstitial nephritis”, but to parenchymal atrophy and fibrosis consequent upon the medullary necrosis, particularly when the latter predisposes to superimposed renal infection. In the absence of diabetes mellitus or obstructive uropathy, phenacetin abuse would appear to be the commonest cause of renal papillary necrosis and parenchymal contraction, but other conditions, including gout, may sometime produce an identical picture.

[1]  S. Yudkin.  Battered Baby Syndrome , 1966, British medical journal.

[2]  V. Lucke,et al.  INTERSTITIAL NEPHROPATHY AND PAPILLARY NECROSIS IN THE DOMESTIC CAT. , 1965, The Journal of pathology and bacteriology.

[3]  M. Marshall.  ABNORMALITIES IN HUMAN SEX-CHROMOSOMES. , 1964, Lancet.

[4]  E. Clausen.  HISTOLOGICAL CHANGES IN RABBIT KIDNEYS INDUCED BY PHENACETIN AND ACETYLSALICYLIC ACID. , 1964, Lancet.

[5]  N. Sanerkin,et al.  Chronic Phenacetin Nephropathy (“Chronic Interstitial Nephritis” with Papillary Necrosis) , 1964, British medical journal.

[6]  A. Rapoport,et al.  Renal damage associated with chronic phenacetin overdosage. , 1962, Annals of internal medicine.

[7]  G. Schreiner.  The nephrotoxicity of analgesic abuse. , 1962, Annals of internal medicine.

[8]  J. Morris,et al.  Renal papillary necrosis and the abuse of phenacetin. , 1962, The Medical journal of Australia.

[9]  A. Mccutcheon.  RENAL DAMAGE AND PHENACETIN , 1962 .

[10]  Peter Ross.  A.P.C. AS A CAUSE OF RENAL DISEASE , 1962, The Medical journal of Australia.

[11]  H. Oe.  Concurrence of gout and renal papillary necrosis. , 1962 .

[12]  K. Terplán,et al.  The Kidney in Gout , 1960, Medicine.

[13]  G. Schreiner,et al.  Renal medullary necrosis. , 1960, The American journal of medicine.

[14]  S. Moolten,et al.  Fatal nephritis in chronic phenacetin poisoning. , 1960, The American journal of medicine.

[15]  K. Larsen,et al.  A renal lesion caused by abuse of phenacetin. , 2009, Acta medica Scandinavica.

[16]  N. I. Nissen,et al.  Necrosis of the renal papillae and prolonged abuse of phenacetin. , 2009, Acta medica Scandinavica.

[17]  J. Hoogstraten,et al.  RENAL PAPILLARY NECROSIS1 , 1959 .

[18]  K. Schourup.  Necrosis of the renal papillae; post-mortem series. , 2009, Acta pathologica et microbiologica Scandinavica.

[19]  A. Thal.  Selective renal vasospasm and ischemic renal necrosis produced experimentally with staphylococcal toxin: observations on the pathogenesis of bilateral cortical necrosis. , 1955, The American journal of pathology.

[20]  A. Grollman,et al.  Papillary necrosis of the kidney; a clinical and experimental correlation. , 1950, Journal of the American Medical Association.

[21]  P. Kimmelstiel.  Acute hematogenous interstitial nephritis. , 1938, The American journal of pathology.

[22]  H. Sheehan.  MEDULLARY NECROSIS OF THE KIDNEYS , 1937 .