Rosehip tea as a possible cause of acute interstitial nephritis

Abstract

Abstract Background Acute interstitial nephritis (AIN) is characterized by an inflammatory infiltrate in the renal interstitium. The etiology of AIN is broad with the most common cause being medications. Treatment includes removal of the offending agent, glucocorticoid therapy, and immunosuppression. Rosehips are a fruit produced from wild roses that are often used in teas and herbal supplements. They are reported to have anti-inflammatory effects and sought after for this purported benefit. Case presentation We present a case of a 67-year-old woman who presented with acute kidney injury after two months of excessive rosehip tea consumption. She was dialyzed for 1 month and treated with oral steroids. Her initial renal biopsy revealed AIN, a thin glomerular basement membrane, and five nodular sclerosed glomeruli. Her work-up was negative for known causes of AIN and the etiology was determined to be rosehip tea. Two months after initial presentation she continued to have clinical and pathologic signs of AIN. She was started on mycophenolate mofetil (MMF) with clinical improvement. Conclusion Rosehip tea is known to have diuretic properties and, when consumed, may lead to a self-perpetuating cycle of intake. Excessive consumption may lead to increased concentrations of arachidonic acid and its metabolites. These metabolites have been shown to perpetuate an inflammatory response capable of causing AIN. Providers should be aware when counseling patients that excessive intake of rosehip tea may lead to AIN.