Acute kidney injury is commonly observed in patients with multiple myeloma and other plasma cell dyscrasias. The pathophysiologic causes, however, are varied. We report a case of a severe ‘drug reaction with eosinophilia and systemic symptoms’ syndrome associated with acute interstitial nephritis in a patient with multiple myeloma likely related to the administration of lenalidomide. This disease entity requires prompt recognition and cessation of the offending drug and often treatment with high-dose corticosteroids.
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