Antitubular Basement-Membrane Antibodies in Methicillin-Associated Interstitial Nephritis

Abstract

Abstract Antitubular basement-membrane antibodies were detected by indirect immunofluorescence in the serum of a patient in whom severe renal failure developed while he was receiving methicillin. A renal biopsy showed a severe mononuclear interstitial infiltrate with focal areas of tubular degeneration. IgG, C3 and a methicillin antigen assumed to be dimethoxyphenylpenicilloyl were present in a linear pattern along the tubular basement membrane but not along the glomerular basement membrane. The dimethoxyphenylpenicilloyl-tubular-basement-membrane hapten protein conjugate apparently led to an immune response with antitubular basement-membrane antibodies being involved in the immunopathogenesis of the patient's interstitial nephritis. (N Engl J Med 291:381–384, 1974)