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EXTENSIVE experience with tetracycline has led to the general conclusion that serious toxic effects are very unusual. However, cases of hepatic disease associated with tetracycline have been reported recently. 1-9 The first reports were of pregnant Negro women with infection of the urinary tract; later reports included less well documented cases in a man, 9 a child, 3 and nonpregnant women. 3,6 Another potentially fatal side effect of this antibiotic drug is nephrotoxicity. Acute renal failure associated with tetracycline is not accompanied by oliguria. In the presence of a normal urine volume, increasing azotemia is easily overlooked as a possible cause for rapid deterioration of a patient. Hepatic disease associated with this drug is frequently accompanied by renal failure, which may be overlooked because the clinical manifestations of hepatic failure are more striking. A case of a pregnant woman with acute hepatic and renal failure without oliguria is reported. Report of a Case A