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Acute interstitial nephritis — RACP Paediatrics MCQ

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HardNephrologyAcute interstitial nephritisRACP Paediatrics

A 10-year-old develops fever, rash, eosinophilia, and AKI 10 days after starting amoxicillin for a UTI. Urinalysis shows sterile pyuria and white cell casts. Eosinophiluria is present. What is the most likely cause of the AKI?

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Correct answer: E — Acute interstitial nephritis

Fever, rash, eosinophilia, sterile pyuria, eosinophiluria, and AKI temporally related to drug administration (commonly beta-lactam antibiotics, NSAIDs, or PPIs) is characteristic of acute interstitial nephritis (AIN). Management includes stopping the offending drug. Corticosteroids may be considered if renal function does not improve after drug withdrawal.

Reference: RCH Melbourne – 2023 – AKI CPG; RACP Paediatric Curriculum – Nephrology