Granulomatous interstitial nephritis: a rare diagnosis with an overlooked culprit.
chronic renal failure
contraindications and precautions
renal system
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
10 Aug 2019
10 Aug 2019
Historique:
entrez:
12
8
2019
pubmed:
12
8
2019
medline:
31
1
2020
Statut:
epublish
Résumé
Granulomatous interstitial nephritis (GIN) is a rare entity identified in <1% of native kidney biopsies. The most frequent aetiology is drug-related, followed by systemic granulomatous conditions. Among drugs implicated in GIN, antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequent. We report the case of a 45-year-old white man referred to a nephrology consult due to chronic kidney disease. He had a history of arterial hypertension with 10 years of evolution, hyperuricaemia, medicated with allopurinol and NSAID abuse for at least 20 years. Urine sediment was blunt, without proteinuria. Renal ultrasound was normal. A kidney biopsy revealed well-defined epithelioid granulomas with glomerular wrinkling and collapse. Infectious and systemic conditions were excluded, favouring the hypothesis of drug-induced GIN, probably related to NSAIDs. Kidney biopsy remains the gold standard for the diagnosis of GIN. Facing a patient with renal failure without significant proteinuria or active sediment, one should look for causes of tubulointerstitial injury.
Identifiants
pubmed: 31401569
pii: 12/8/e229159
doi: 10.1136/bcr-2018-229159
pmc: PMC6700544
pii:
doi:
Substances chimiques
Anti-Inflammatory Agents, Non-Steroidal
0
Creatine
MU72812GK0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
CMAJ. 1986 Sep 1;135(5):496-7
pubmed: 3742391
Clin Nephrol. 2017 Supplement 1;88(13):97-100
pubmed: 28655390
Clin Kidney J. 2015 Oct;8(5):516-23
pubmed: 26413275
J Rheumatol. 1994 Sep;21(9):1742-7
pubmed: 7799360
Clin Kidney J. 2012 Jun;5(3):234-6
pubmed: 26069773
Clin J Am Soc Nephrol. 2007 Mar;2(2):222-30
pubmed: 17699417
Kidney Int. 2008 Apr;73(8):940-6
pubmed: 18185501
Medicine (Baltimore). 2007 May;86(3):170-180
pubmed: 17505256
BMC Res Notes. 2015 Dec 16;8:793
pubmed: 26674186
Nephrol Dial Transplant. 2003 Feb;18(2):280-4
pubmed: 12543881
J Exp Med. 1898 Jul 1;3(4-5):393-420
pubmed: 19866889
Am J Nephrol. 1988;8(5):410-6
pubmed: 3071148
J Coll Physicians Surg Pak. 2018 Nov;28(11):885-887
pubmed: 30369386
Am J Kidney Dis. 2003 Mar;41(3):714-9
pubmed: 12612999
Int J Surg Pathol. 2006 Jan;14(1):57-63
pubmed: 16501836
Q J Med. 1981 Spring;50(198):137-48
pubmed: 7302115
J Immunother Cancer. 2017 Jul 18;5(1):57
pubmed: 28716106
Am J Pathol. 1946 Jul;22(4):703-35
pubmed: 19970888
Hum Pathol. 1995 Dec;26(12):1347-53
pubmed: 8522308
Case Rep Nephrol. 2016;2016:1971465
pubmed: 26955492
Am J Kidney Dis. 2000 Oct;36(4):E27
pubmed: 11007702
Adv Nephrol Necker Hosp. 1984;13:219-45
pubmed: 6433667
Adv Chronic Kidney Dis. 2017 Mar;24(2):72-79
pubmed: 28284382