Nephropathy Associated with Penicillin and Homologues

Abstract

The various penicillins are relatively non-toxic, but can cause diverse allergic manifestations. Recognized renal involvement is rare; only 23 reports in the world''s literature have related this to therapy with penicillin or its homologues. In these reports, a glomerulonephritic picture was most common, but arteritis was more frequently associated with a fatal outcome. Four new cases are reported, one related to methicillin, and three to penicillin therapy. All 4 had other stigmata of allergy. Renal tissue of 2 patients was examined; both showed vasculitis. The other 2 developed progressive renal disease with associated allergic manifestations. Three patients had underlying chronic renal disease. The difficulty in proving a cause and effect relationship between penicillin or any sensitizing agent and specific renal lesions is discussed.