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At least 127 records · Page 7Linked to original sources

Ciprofloxacin-induced granulomatous interstitial nephritis and localized elastolysis.

Ciprofloxacin is known to cause acute interstitial nephritis. We report the first case of ciprofloxacin-induced granulomatous interstitial nephritis and localized elastolysis. The patient presented with acute renal failure and skin lesions following a 14-day course of ciprofloxacin administered for cellulitis. The patient had symmetric, palm-sized, tender violaceous plaques on both axillae. The renal biopsy revealed granulomatous interstitial disease. A skin biopsy revealed an elastolytic process with histocytic infiltration and calcification. After discontinuing ciprofloxacin and starting a short course of steroid therapy, the skin lesion and renal function improved promptly. The nephritis relapsed after prednisone was discontinued and responded to a second course of steroid therapy. Ciprofloxacin, like penicillin, can cause granulomatous interstitial nephritis and elastolysis. A prolonged course of steroid therapy may be indicated in patients with ciprofloxacin-induced granulomatous interstitial nephritis to avoid early relapse.

Ciprofloxacin↗

Acute interstitial nephritis due to amoxicillin therapy.

Acute interstitial nephritis (AIN) has been reported in association with therapy with a number of drugs. We report a patient who developed drug-related AIN while receiving intravenous amoxicillin therapy. The patient developed rash, secondary temperature elevation, and eosinophilia in association with nonoliguric renal failure. Renal biopsy showed evidence for AIN and the renal failure was responsive to corticosteroid therapy. AIN may occur in patients receiving any drug of the penicillin class. This reversible form of acute renal failure must not be overlooked in patients with other forms of renal disease.

Acute Disease↗

Hyperreninemia, hypertension, and congestive heart failure in focal interstitial nephritis.

Hyperreninemia probably due to focal interstitial nephritis of the right kidney caused an acute onset of hypertension and cardiac dysfunction including valvular insufficiency in a 5-year-old boy. This congestive heart failure in association with valvular insufficiency and hypertension was dramatically improved following right nephrectomy. Abruptly activated renin-angiotensin II may lead to congestive heart failure and valvular dysfunction without myocardial hypertrophy in a young heart.

Aortic Valve Insufficiency↗

A case of acute interstitial nephritis induced by flurbiprofen.

Recently, acute interstitial nephritis (AIN) presenting nephrotic syndrome and renal failure induced by nonsteroidal anti-inflammatory drug (NSAID) has been recognized with increasing frequency. We described here a 43-year-old woman who developed this type of nephropathy after taking NSAID for rheumatoid arthritis. Flurbiprofen (Froben) was assumed to be a causal drug based on a clinical course and a positive result of lymphocyte transformation test. Withdrawal of flurbiprofen therapy led no sufficient improvement, and high-dose steroid therapy done 15 months after the onset resulted in only a minor improvement. So far as we know, this was the second case of AIN associated with flurbiprofen and the youngest in NSAID-induced AIN with irreversible chronic renal insufficiency.

Acute Disease↗

Acute interstitial nephritis complicating Legionnaires' Disease.

An acute interstitial nephritis was found in a patient with sudden renal failure and lung infection caused by Legionella pneumophilia. Our patient regained and maintained normal renal function after a short period of dialysis support. The diagnosis should be considered in any patient with a chest infection complicated by acute renal failure especially if confusion is disproportionate to the degree of uremia.

Acute Disease↗

Primary chronic interstitial nephritis in Crohn's disease.

BACKGROUND & AIMS: In Crohn's disease, cases of interstitial nephritis with renal failure have been reported in connection with the use of mesalamine. METHODS: We observed 4 patients with severe interstitial nephritis proven by examination of kidney biopsy specimens. Renal failure was discovered before or simultaneously with the diagnosis of Crohn's disease, and patients were not treated with mesalamine. Impairment of renal function progressed to end-stage renal failure in 3 of the 4 patients. RESULTS: Our results show that the kidney can be an extraintestinal target of Crohn's disease. CONCLUSIONS: Several unanswered questions remain concerning the frequency of interstitial nephritis in patients with Crohn's disease, as well as the exact role of mesalamine in the development of chronic interstitial nephritis.

Adult↗

Suspected nafcillin-induced interstitial nephritis.

OBJECTIVE: To present a case of nafcillin-induced interstitial nephritis. METHODOLOGY: Case report and literature review. SETTING: Hospital. RESULTS: Three days following initiation of nafcillin therapy for staphylococcal pneumonia, an 80-year-old woman developed allergic manifestations and progressive renal impairment suggestive of acute allergic interstitial nephritis. These manifestations were completely reversed within 96 hours of cessation of nafcillin therapy. CONCLUSIONS: In the clinical setting of acute renal failure in a patient on nafcillin therapy, acute interstitial nephritis should be considered. Prompt cessation of nafcillin therapy has generally been associated with reversal of symptoms and an improvement in renal function.

Acute Disease↗

Acute interstitial nephritis in Singapore: a report of five cases.

Interstitial nephritis is an uncommon cause of acute renal failure. Reported incidence varies widely in the literature and may depend on several factors i.e. geographical location, diagnostic criteria, dietary, environmental factors and therapeutic practices. This is a retrospective study of biopsy proven interstitial nephritis in National University Hospital Singapore. We report five cases out of a total of 349 biopsies carried out during a five-year period between September 1997 and August 2002. Four patients presented acutely with fever and or cough. In four patients, there was exposure to traditional Chinese medications and/or drugs. Renal failure in four out of the five patients progressed rapidly, three of whom required dialysis. One patient was treated with steroids. Renal function recovered in all patients with one patient who had significant residual renal impairment after one month.

Acute Disease↗

Celecoxib-induced acute interstitial nephritis.

Data about the nephrotoxicity of selective cyclooxygenase-2 inhibitors are still evolving. Acute interstitial nephritis is a well-described complication of therapy with nonselective nonsteroidal anti-inflammatory drugs. We report a case of biopsy-proven acute interstitial nephritis in a 73-year-old diabetic woman, who had taken celecoxib for more than 1 year before presentation. She presented with clinical findings of subnephrotic proteinuria and acute renal failure that required dialysis. She recovered renal function with cessation of celecoxib therapy after 2 weeks. Other medications were reintroduced safely, without recurrence of renal failure. A kidney biopsy specimen showed acute interstitial nephritis with a prominent eosinophilic infiltrate in the interstitium. This case documents the occurrence of acute interstitial nephritis with celecoxib and emphasizes the need for continued vigilance and care in use of cyclooxygenase-2 inhibitors in high-risk patients.

Acute Kidney Injury↗

Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication.

Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

False Negative Reactions↗

[Detection of Epstein-Barr virus DNA in renal tissue from patients with interstitial nephritis].

In order to demonstrate whether Epstein-Barr virus (EBV) infection might play a role in the pathogenesis of interstitial nephritis as suggested by many scholars, EBV DNA was detected in twelve specimens of frozen renal biopsy tissue from patients with interstitial nephritis by using nest polymerase chain reaction (nest PCR). For comparison, frozen renal biopsy tissue from ten patients with minimal change disease was used as control. Southern blot hybridization was used to check the specificity of PCR product. The results showed that eight of twelve frozen renal biopsy specimens from interstitial nephritis patients were EBV DNA positive (66.7%), as compared with negative in all the ten frozen renal specimens from minimal change disease patients. The differences was statistically significant (P < 0.01). The study strongly suggests that EBV infection may play an important role in the pathogenesis of interstitial nephritis. The location of EBV in renal tissue and the mechanism inducing interstitial nephritis by EBV are to be clarified.

Adult↗

Prediction of the long-term outcome in acute interstitial nephritis.

Fourteen patients with acute interstitial nephritis have been followed for an average of 64 months. Initial renal failure estimated by a reciprocal of serum creatinine improved rapidly and linearly within 6 to 8 weeks ("early improvement"). A slow improvement of GFR followed within one year, showing a new base line level of renal function, which was assessed as normal in five patients and was reduced in seven patients. Two patients died of non-renal disease. Final GFR was closely correlated with a degree of "early improvement", ages at onset and severity of interstitial lesions. The results suggest, 1) these indices are of much value in predicting long-term prognosis and 2) a certain degree of permanent impairment of renal function is rather common in the disease.

Acute Disease↗

Sarcoidosis with granulomatous interstitial nephritis: report of three cases.

Three cases of sarcoidosis with granulomatous interstitial nephritis are reported. Patients were all male and over 50 years of age. They simultaneously had evidence of multiorgan involvement of sarcoidosis including lung and skin and/or eye. In addition, distinct features were found in each case: a granulomatous infiltration mimicking unilateral renal tumor (case 1); renal insufficiency solely due to granulomatous interstitial nephritis (case 2); and renal insufficiency with calcemic nephropathy and granulomatous interstitial nephritis (case 3). Prednisolone therapy resulted in disappearance of the pseudotumor in case 1 and partial improvement of renal function in cases 2 and 3. In cases 2 and 3, however, plasma creatinine did not return to normal values and a second renal biopsy in case 2 demonstrated residual interstitial fibrosis and few granulomas, suggesting that steroid therapy did not achieve complete reversal of changes.

Aged↗

Idiopathic hypocomplementemic interstitial nephritis with extensive tubulointerstitial deposits.

Most forms of interstitial nephritis are cell mediated and lack tubulointerstitial immune deposits. These forms include allergic, infectious, and idiopathic interstitial nephritis. Immune complex deposits in the tubular basement membranes and interstitium most commonly are encountered in conjunction with glomerular diseases. Predominantly tubulointerstitial immune deposits without significant glomerular involvement can occur in Sjögren's syndrome and in a small subset of lupus nephritis. We report eight unusual cases of tubulointerstitial nephritis with massive tubulointerstitial immune deposits occurring in adults with hypocomplementemia and no evidence of systemic lupus erythematosus or Sjögren's disease. Most patients were older men. The renal biopsy specimens manifested a spectrum of changes ranging from tubulointerstitial nephritis to atypical lymphoid hyperplasia to changes suggestive of marginal zone B-cell lymphoma. Chronic local antigenic stimulation may predispose to lymphoma in these cases, analogous to what is postulated to occur in cases of mucosa-associated lymphoid tissue (MALT) lymphomas in extranodal sites, such as salivary gland, stomach, and thyroid. The preferential tubulointerstitial immune deposition and significant interstitial plasma cell component suggest pathomechanisms that involve local immune complex formation.

Adult↗

[Structure of interstitial nephritis in children].

The authors provide the data on 24 cases of interstitial nephritis in children treated at the Nephrological Center of the city of Kuibyshev in 1986-1990. Describe the etiological structure of interstitial nephritis using the classification developed by N. A. Korovina and coworkers (1982), randomization according to the age, sex, and the disease course. Demonstrate the predominance of the postviral and toxicoallergic disease patterns in children of the early, preschool and junior school age. Estimate the importance of the types of urine proteinograms in the diagnosis of interstitial nephritis.

Acute Disease↗

Acute interstitial nephritis associated with Yersinia pseudotuberculosis infection.

We report two cases of acute interstitial nephritis associated with Yersinia pseudotuberculosis infection. The patients had fever, abdominal pain, vomiting and acute renal failure coinciding with elevated agglutination antibody titer for Y. pseudotuberculosis. Renal biopsy revealed interstitial nephritis in both patients. Although it is well known that yersiniosis sometimes affects glomeruli, this is the first report to demonstrate acute interstitial nephritis in patients with Y. pseudotuberculosis infection.

Acute Disease↗

Acute interstitial nephritis. A clinical and pathologic study based on renal biopsies.

To define interstitial nephritis without preselection bias, 25 consecutive renal biopsy specimens from patients with tubular damage, interstitial damage and interstitial inflammation were analyzed in detail. In four patients (all with acute renal failure), tubulitis, and interstitial eosinophil and lymphocyte infiltration were found, but no glomerular abnormalities. In four others, the findings were similar but some glomerular abnormalities were noted. Two patients had probable healed interstitial nephritis. The clinical presentation varied from transient renal insufficincy to oliguric renal failure. Three of the patients with glomerular abnormalities had significant proteinuria. When the 10 patients with interstitial nephritis were compared with the other 15 serving as controls, striking features in the former group were skin rash, eosinophilia, the absence of hypertension and the frequency of administration of penicillin and its analogs. Serum immunoglobulin E (IgE) levels were elevated in three of the patients. The striking eosinophilia, interstitial eosinophil infiltration and increased IgE levels suggest that allergen-reaginic complexes may be involved in the pathogenesis of the lesion.

Acute Disease↗