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In a handful of case reports, ciprofloxacin has been implicated as a cause of acute renal failure; an immune-mediated pathogenesis has been suggested. Now, authors in Italy present two cases of possible ciprofloxacin-induced crystal nephropathy.
In both cases, elderly patients with baseline serum creatinine around 1.0 mg/dL received 750 mg of oral ciprofloxacin twice daily. Serum creatinine peaked at 7.0 mg/dL in one patient and at 8.3 mg/dL in the other. Renal biopsy in both cases revealed needle-shaped stellate birefringent crystals within some renal tubules. The crystals, which stained negatively for calcium and phosphate, appeared identical to ciprofloxacin crystals described in previous reports. Both patients recovered after ciprofloxac…