Association of Acute Interstitial Nephritis with Carnivora, a Venus Flytrap Extract, in a 30-Year-Old Man with Hodgkin's Lymphoma

Abstract

Acute interstitial nephritis (AIN) is a common cause of acute kidney injury and has been associated with a variety of medications. This is the case of 30-year-old man with Hodgkin's lymphoma who on routine labs before chemotherapy was found to have acute nonoliguric renal failure. A kidney biopsy was performed and confirmed the diagnosis of acute interstitial nephritis. The patient had taken several medications including a higher dose of Carnivora, a Venus flytrap extract, composed of numerous amino acids. The medication was discontinued and kidney function improved towards the patient's baseline indicating that this may be the possible cause of his AIN. Proximal tubular cell uptake of amino acids increasing transcription of nuclear factor-kappaB is a proposed mechanism of AIN from this compound.

Figure 1

CT scan with oral contrast showing enlarged 15 cm right kidney and 14.5 cm left kidney with no hydronephrosis.

Figure 2

Photomicrograph showing active interstitial nephritis with acute tubulitis and mixed interstitial inflammation including numerous eosinophils. I: interstitial inflammation, arrows: eosinophils, and box: active tubulitis (H&E 30x magnification).

Figure 3

Electron microscopy showing lack of podocyte effacement or glomerular basement membrane changes. Arrows: intact foot processes, P: podocytes (original mag. = 3500x).