Vedolizumab induced acute interstitial nephritis.

Vedolizumab is a gut selective anti-integrin monoclonal antibody with a very good and proven safety profile in the treatment of ulcerative colitis (UC). This case report highlights a rather unusual complication that every gastroenterologist ought to be aware of. It relates to the association of acute interstitial nephritis with vedolizumab usage in the management of UC. A 53-year-old man with liver cirrhosis due to Primary Sclerosing Cholangitis and UC was treated with vedolizumab following failed therapy with thiopurines and mesalazine. This led to improvement in his bowel function but his renal function steadily declined over subsequent months, in the presence of reactive urinary sediments. A subsequent renal biopsy demonstrated acute interstitial nephritis. Cessation of vedolizumab, along with high dose steroids treatment, led to near complete resolution of his renal failure.