TIOPRONIN AND/OR NSAID? A CASE OF NEPHROTIC SYNDROME AND ACUTE INTERSTITIAL NEPHRITIS IN A YOUNG WOMAN WITH CYSTINURIA

Cystinuria is an autosomal recessive disease that leads to recurrent stone formation.Tiopronin, a glycine derivative with a free thiol similar to penicillamine, prevents stone formation and facilitates their dissolution. Nephrotic-range proteinuria is a serious and relatively uncommon adverse effect, reported in 6-10% of patients, most frequently during the first year of tiopronin use. Various patterns of morphologic kidney injury have been associated with tiopronin use, including MCD, MN, and MPGN. Acute interstitial nephritis can be caused virtually by any drug. Non-steroidal anti-inflammatory drugs (NSAID s) may cause AIN, with or without nephrotic syndrome due to minimal change disease or membranous nephropathy.