Acute interstitial nephritis: immunologic and clinical aspects.

Abstract

Acute interstitial nephritis is a common renal syndrome that may be associated with a variety of infections and drug therapies or may develop without an identified cause. Three cases are presented to illustrate the three types of acute interstitial nephritis--drug related, infection related, and idiopathic. Cell-mediated immune mechanisms seem to be more important than humorally mediated mechanisms in the pathogenesis of acute interstitial nephritis. Frequently, eosinophils are identified as a component of the interstitial cellular infiltrate, and eosinophiluria and eosinophilia have been claimed to be helpful in the diagnosis of acute interstitial nephritis, especially the drug-induced type. Neither eosinophiluria nor the presence of increased urinary levels of eosinophil major basic protein, however, is specific for the diagnosis of acute interstitial nephritis. Patients with drug-induced interstitial nephritis frequently have symptoms and signs suggestive of a hypersensitivity syndrome and rarely have more dramatic anaphylactic manifestations. Systemic glucocorticoids have been shown to be beneficial in this type of acute interstitial nephritis.

• Authors: R M Ten, V E Torres, D S Milliner, T R Schwab, K E Holley, G J Gleich
• Journal: Mayo Clinic proceedings (Mayo Clin Proc) Vol. 63 Issue 9 Pg. 921-30 (Sep 1988) ISSN: 0025-6196 [Print] England
• PMID: 3045437 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antihypertensive Agents
• Glucocorticoids

Topics

• Acute Disease
• Adolescent
• Antihypertensive Agents (adverse effects)
• Biopsy
• Drug Hypersensitivity (complications)
• Eosinophilia (urine)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Immunity, Cellular
• Infections (complications)
• Infectious Mononucleosis (complications)
• Male
• Middle Aged
• Nephritis, Interstitial (diagnosis, drug therapy, etiology, immunology, pathology)