Renal Involvement as Rare Acute Tubulointerstitial Nephritis in a Patient with Eosinophilic Disorder Treated with Early Add-on Administration of Mepolizumab.

Abstract

A 39-year-old man presented with peripheral eosinophilia, pulmonary eosinophilic infiltrate, and renal failure due to acute tubulointerstitial nephritis (TIN). He had experienced childhood asthma and was negative for anti-neutrophil cytoplasmic antibody (ANCA). He was tentatively diagnosed with ANCA-negative eosinophilic granulomatous polyangiitis (EGPA) or idiopathic hypereosinophilic syndrome (HES). Renal involvement of isolated TIN with eosinophil infiltration is rare in EGPA and HES and does not seem to have a good prognosis in the literature. However, his condition improved well with corticosteroids and mepolizumab. The revised classification of EGPA based on the etiology should dictate the proper treatment in suspected EGPA patients with nonsystemic vasculitis.

• Authors: Yuto Hayama, Fuminori Tomyo, Masaki Ueno, Shinichiro Asakawa, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Makoto Mochizuki, Ryuji Ohashi, Shigeru Shibata, Yoshihide Fujigaki
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 60 Issue 23 Pg. 3759-3764 (Dec 01 2021) ISSN: 1349-7235 [Electronic] Japan
• PMID: 34092738 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• mepolizumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized
• Child
• Churg-Strauss Syndrome (complications, diagnosis, drug therapy)
• Granulomatosis with Polyangiitis
• Humans
• Male
• Nephritis, Interstitial (chemically induced, diagnosis, drug therapy)