Propylthiouracil and methimazol are frequently used in the management of hyperthyroidism. Adverse reactions of antithyroid drug occur in 1-5% of patients. The major side effects, namely agranulocytosis, hepatitis, hypersensitivity vasculitis and
lupus-like syndromes are not distince entities and there can be overlaps in the clinical manifestation. The drug-induced hypersensitivity may be immune-mediated reaction with multiorgan involvement.
Renal impairment caused by antithyroid drugs is extremely rare. Only the case of focal glomerular mesangial and membraneous thickening due to propylthiouracil and that of nephrotic syndrom due to methimazol have been described. There have been no
case
of acute interstitial nephritis due to antithyroid drugs in review of literature.
We report a patient with unusual combination of fever, purpuric skin rash, proteinuria, eosinophilia, thrombocytopenia, hepatitis and acute interstital nephritis. The patient recovered promptly after withdrawal of antithyroid drugs and the
response
of
steroid treatment was good. The clinical manifestations of renal impairment were similar to acute interstitial nephritis due to durgs such as methicillin. We propose that renal impairment of this case is an acute interstitial nephritis due to
hypersensitivity of antithyroid drugs.
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