Acute Renal Failure and Rhabdomyolysis After Ingestion of Phenylpropanolamine-Containing Diet Pills

Abstract

PHENYLPROPANOLAMINE hydrochloride is a sympathomimetic agent found in more than 70 over-the-counter appetite suppressants and nasal decongestants. Acute amphetaminelike CNS stimulation and hypertension, reviewed elsewhere,¹and acute renal failure²have been associated with phenylpropanolamine use. We describe two patients with acute renal failure and rhabdomyolysis following the ingestion of phenylpropanolamine, suggesting that muscle injury may contribute to the renal insult. <h3>Report of Cases</h3><h3>Case 1.—</h3> The patient is the subject of an earlier correspondence.³Acute renal failure developed in a 28-year-old woman after three weeks of ingesting an appetite suppressant containing phenylpropanolamine (Full-stop). She manifested symptoms, signs, and laboratory evidence of rhabdomyolysis and recovered with conservative treatment of her renal failure. She also received ampicillin trihydrate for<i>Escherichia coli</i>bacteriuria. Percutaneous renal biopsy disclosed acute interstitial nephritis, which could have been due to drug ingestion or pyelonephritis. Although it is possible that the renal failure was the