초록
환자는 내원 2주 전부터 건강증진 목적으로 산수유 차를 매일 복용하였으며 내원 2일 전부터 육안적 혈뇨와 단백뇨를 주소로 본원에 내원하였다. 혈액검사에서 혈청크레아티닌은 내원 3개월 전 0.8 mg/dL에서 1.7 mg/dL로 증가되어 있었고 소변 검사에서 요단백 1+, 적혈구 many/HPF, 백혈구 0-3/HPF이었다. 신장 조직 검사 결과 급성 간질성 신염 소견을 확인하였으며 원인 물질의 제거 및 수분 전해질 균형 조절 등의 보존적 치료로 점진적으로 양호한 경과를 나타내었다. 간질성 신염의 발생 기전은 아직 밝혀져 있지 않으며 다양한 약물로 인해 발생할 가능성을 염두에 두어야 한다.
Drug-induced interstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Corni fructus-induced interstitial nephritis has not been reported in the general population. A 65-year-old female patient was admitted with sudden onset of gross hematuria after ingesting Corni fructus tea for 2 weeks. Her initial lab findings showed a blood urea nitrogen level of 35.1 mg/dL, creatinine level of 1.7 mg/dL, albumin level of 4.5 g/dL, and hemoglobin level of 10.3 g/dL. Urinalysis revealed SG (1.025), blood (many), protein (+), and WBC (0-3/HPF). Her 24-hour total protein level was 1,120 mg/day. No specific abnormalities were found on serum and urine protein electrophoresis. Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy and pericapsular fibrosis. Immediate withdrawal of Corni fructus, appropriate education, and conservative management resulted in gradual restoration of her renal function. This case implies that Corni fructus may be a causative allergen that induces acute interstitial nephritis in some patients.