ABSTRACT
Two patients developed nephropathy caused by the ingestion of Chinese herbal remedies containing aristolochoic acids I and II.
Patient 1: A 49-year-old woman developed headaches and hypertension during treatment with a Chinese herbal remedy for two years for eczema. No other medications were taken by the patient. Renal function tests were elevated, including creatinine (662 μπιοΙ/L) and urea (35.7 mmol/L). Other exams were negative or within normal limits, including antineutrophil cytoplasmic antibody, antinuclear antibody, complement, immunoglobulins and serum elec trophoresis. Urinalysis was sterile and revealed proteinuria. Renal ultrasound demonstrated echogenic kidneys (8.4 cm and 7.9 cm) and biopsy revealed tubular atrophy and interstitial fibrosis in the cortex. The patient progressed to end stage renal failure, requiring dialysis and eventual kidney transplantation.
