Drug-induced renal injury represents a frequent clinical entity. The most common drugs associated with acute tubular
necrosis are
aminoglycosides,
amphotericin B,
radiocontrast agents, and
cyclosporine, but no data exist about the potential renal toxicity due to
anthelmintics administration.
Anthelmintics are commonly considered quite safe agents, and side effects such as gastrointestinal, neurologic, hematologic, or hepatic injury have been only rarely described. We report a 4-year-old boy with persistent massive
proteinuria without any other symptoms/signs suggesting
nephrotic syndrome (NS). The only relevant anamnestic data was the administration of
pyrantel pamoate due to
oxyuriasis 7 days before the
proteinuria development. The patient was affected by NS diagnosed 6 months before and treated with a 12-week course of
corticosteroids. During follow-up, carried out at 3 and 6 months after discharge, he did not show further episodes of
proteinuria, and no clinical symptoms/signs suggesting a relapse of NS were ever detected. Considering that the
proteinuria observed in our patient spontaneously disappeared after 10 days without any treatment, apart from the interruption of the
anthelmintic therapy, we would like to alert pediatricians about the possible occurrence of
anthelmintics-related renal complications especially among predisposed patients and to perform a watchful waiting not considering the presence of even massive
proteinuria as a certain sign of NS relapse.