A 28-year-old woman presents 5 days after starting ibuprofen for menstrual cramps with fever (39.2°C), diffuse maculopapular rash, and arthralgias. Vital signs: HR 102/min, BP 128/76 mmHg, RR 18/min, SpO2 98% on room air. Serum creatinine is 2.8 mg/dL (baseline 0.8), eosinophils 12%, and urinalysis shows WBC casts and eosinophiluria. Chest imaging is unremarkable. Which of the following is the most likely diagnosis?
- A)Acute interstitial nephritisGABARITO
- B)Acute tubular necrosis
- C)Drug-induced systemic lupus erythematosus
- D)IgA nephropathy
- E)Prerenal azotemia from dehydration
Explicação
Acute interstitial nephritis is a hypersensitivity reaction typically presenting 5-7 days after drug exposure. Classic triad: fever, rash, and AKI. NSAIDs are a common culprit. Urinalysis shows WBC casts, pyuria, and eosinophiluria (detected by Hansel stain). ... Ver explicação completa e trilha adaptativa →