Acute interstitial nephritis associated with ondansetron

A 16-year-old male presented with seizure to an outside hospital and was found to have severe kidney dysfunction of unknown chronicity. He had dilute urine throughout the hospitalization and a negative serological work-up for acute glomerulonephritis. Exposure history was notable for 1–2 doses of ibuprofen and ondansetron use for nausea for the 3–4 days prior to the admission. All prior medications were discontinued, and he was started on levetiracetam for seizure management. Kidney function markedly improved on hospital day 4, and a planned kidney biopsy was cancelled. Kidney function continued to normalize after discharge. He experienced nausea again 10 days after discharge and took another dose of ondansetron with increased creatinine noted 1 day later. After discontinuation of ondansetron, his kidney function returned to and has remained normal.