We report a 77 year old female with well-controlled hypertension who presented with lethargy. She had received antimicrobial treatment with ceftriaxone, levofloxacin and clarithromycin for acute sinusitis and pneumonia 2 weeks prior to presentation. Serum creatinine was 51 µmol/L then. At presentation, she had acute kidney injury with peak serum creatinine of 482 µmol/L and required dialysis. Urine analysis noted few iso-morphic red blood cells and white blood cells and proteinuria of 2.03 g/24 hours.
Granulomatosis with polyangiitis with acute tubulointerstitial nephritis in absence of glomerulonephritis
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