Rabeprazole-induced acute interstitial nephritis: A case report

Rabeprazole, a proton-pump inhibitor (PPI), commonly used in the treatment of gastroesophageal reflux disease, a condition caused due to regurgitation of acid from the stomach to the esophagus. Acute interstitial nephritis (AIN) is seen uncommonly even though it is an important adverse effect of these class of drugs. Here, we report a case of a 47-year-old male patient, a known case of peptic ulcer disease since 2 months, now presented with complaints of nausea and abdominal pain. He was on treatment with rabeprazole for the same. At the time of admission, his serum creatinine level (4.86 mg/dl) and blood urea nitrogen (75 mg/dl) were elevated. Ultrasonography showed changes in the renal parenchymal cells, and renal biopsy report was also suggestive of AIN. Rabeprazole-induced AIN was doubted, and thus, the drug therapy was stopped on the day four. He was symptomatically and clinically better after discontinuation of the drug. Using the Naranjo adverse drug reaction scale, we conclude that the probability of the incidence of AIN being induced by rabeprazole is probable (Naranjo probability score was eight). Early diagnosis of the adverse effect due to PPIs is essential for the instant withdrawal of the offending drug and resolution of symptoms.