A Case of Acute Tubulointerstitial Nephritis and Uveitis Syndrome with a Dramatic Response to Corticosteroid Therapy

1989 ◽  
Vol 9 (6) ◽  
pp. 499-503 ◽  
Author(s):  
Kiyoshi Hirano ◽  
Yasuhiko Tomino ◽  
Hideaki Mikami ◽  
Kazuki Ota ◽  
Yumiko Aikawa ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Tubulointerstitial Nephritis ◽  
Acute Tubulointerstitial Nephritis

Acute tubulointerstitial nephritis in children and chronic kidney disease

2019 ◽  
Vol 26 (5) ◽  
pp. 290-294 ◽  
Author(s):  
S. Clavé ◽  
C. Rousset-Rouvière ◽  
L. Daniel ◽  
M. Tsimaratos
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tubulointerstitial Nephritis ◽  
Acute Tubulointerstitial Nephritis

scholarly journals Urinary Cytokines Reflect Renal Inflammation in Acute Tubulointerstitial Nephritis: A Multiplex Bead-Based Assay Assessment

2021 ◽  
Vol 10 (13) ◽  
pp. 2986
Author(s):  
Laura Martinez Valenzuela ◽  
Juliana Draibe ◽  
Oriol Bestard ◽  
Xavier Fulladosa ◽  
Francisco Gómez-Preciado ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Urinary Concentration ◽  
Blood Eosinophil ◽  
Acute Tubulointerstitial Nephritis ◽  
Luminex Assay ◽  
Non Invasive ◽  
Urinary Levels ◽  
Histological Data ◽  
The Individual ◽  
Multiplex Bead

Background: Acute tubulointerstitial nephritis (ATIN) diagnosis lays on histological assessment through a kidney biopsy, given the absence of accurate non-invasive biomarkers. The aim of this study was to evaluate the accuracy of different urinary inflammation-related cytokines for the diagnostic of ATIN and its distinction from acute tubular necrosis (ATN). Methods: We included 33 patients (ATIN (n = 21), ATN (n = 12)), and 6 healthy controls (HC). We determined the urinary levels of 10 inflammation-related cytokines using a multiplex bead-based Luminex assay at the time of biopsy and after therapy, and registered main clinical, analytical and histological data. Results: At the time of biopsy, urinary levels of I-TAC/CXCL11, CXCL10, IL-6, TNFα and MCP-1 were significantly higher in ATIN compared to HC. A positive correlation between the extent of the tubulointerstitial cellular infiltrates in kidney biopsies and the urinary concentration of I-TAC/CXCL11, MIG/CXCL9, CXCL10, IL17, IFNα, MCP1 and EGF was observed. Notably, I-TAC/CXCL11, IL-6 and MCP-1 were significantly higher in ATIN than in ATN, with I-TAC/CXCL11 as the best discriminative classifier AUC (0.77, 95% CI 0.57–0.95, p = 0.02). A combinatory model of these three urinary cytokines increased the accuracy in the distinction of ATIN/ATN compared to the individual biomarkers. The best model resulted when combining the three cytokines with blood eosinophil and urinary leukocyte counts (LR = 9.76). Follow-up samples from 11ATIN patients showed a significant decrease in I-TAC/CXCL11, MIG/CXCL9 and CXCL10 levels. Conclusions: Urinary I-TAC/CXCL11, CXCL10, IL6 and MCP-1 levels accurately distinguish patients developing ATIN from ATN and healthy individuals and may serve as novel non-invasive biomarkers in this disease.

Cockayne syndrome with recurrent acute tubulointerstitial nephritis

2006 ◽  
Vol 56 (11) ◽  
pp. 678-682 ◽  
Author(s):  
Satoshi Funaki ◽  
Shori Takahashi ◽  
Hitohiko Murakami ◽  
Kensuke Harada ◽  
Hiroshi Kitamura
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Cockayne Syndrome ◽  
Acute Tubulointerstitial Nephritis

scholarly journals Acute Tubulointerstitial Nephritis in a Patient on Anti-Programmed Death-Ligand 1 Triggered by COVID-19: A Case Report

2021 ◽  
Vol 8 ◽  
pp. 205435812110147
Author(s):  
Dimitry Buyansky ◽  
Catherine Fallaha ◽  
François Gougeon ◽  
Marie-Noëlle Pépin ◽  
Jean-François Cailhier ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Tubulointerstitial Nephritis ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
High Dose ◽  
Programmed Death Ligand 1 ◽  
Acute Tubulointerstitial Nephritis ◽  
Programmed Death ◽  
Kidney Involvement

Rationale: Immune checkpoint inhibitors are monoclonal antibodies used in the treatment of various types of cancers. The downside of using such molecules is the potential risk of developing immune-related adverse events. Factors that trigger these autoimmune side effects are yet to be elucidated. Although any organ can potentially be affected, kidney involvement is usually rare. In this case report, we describe the first known instance of a patient being treated with an inhibitor of programmed death-ligand 1 (anti-PD-L1, a checkpoint inhibitor) who develops acute tubulointerstitial nephritis after contracting the severe acute respiratory syndrome coronavirus 2. Presenting concerns of the patient: A 62-year-old patient, on immunotherapy treatment for stage 4 squamous cell carcinoma, presents to the emergency department with symptoms of lower respiratory tract infection. Severe acute kidney injury is discovered with electrolyte imbalances requiring urgent dialysis initiation. Further testing reveals that the patient has contracted the severe acute respiratory syndrome coronavirus 2. Diagnosis: A kidney biopsy was performed and was compatible with acute tubulointerstitial nephritis. Interventions: The patient was treated with high dose corticosteroid therapy followed by progressive tapering. Outcomes: Rapid and sustained normalization of kidney function was achieved after completion of the steroid course. Novel findings: We hypothesize that the viral infection along with checkpoint inhibitor use has created a proinflammatory environment which led to a loss of self-tolerance to renal parenchyma. Viruses may play a more important role in the pathogenesis of autoimmunity in this patient population than was previously thought.

scholarly journals Cilostazol-induced acute tubulointerstitial nephritis accompanied by IgA nephropathy: a case report

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Hisato Shima ◽  
Manabu Tashiro ◽  
Satoshi Yamada ◽  
Motokazu Matsuura ◽  
Kazuyoshi Okada ◽  
...  
Keyword(s):  
Case Report ◽  
Iga Nephropathy ◽  
Tubulointerstitial Nephritis ◽  
Acute Tubulointerstitial Nephritis

scholarly journals Acute tubulointerstitial nephritis and IgM deposits on glomerular capillary walls after immunotherapy with nivolumab for metastatic renal cell carcinoma

2019 ◽  
Vol 9 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Taisuke Irifuku ◽  
Ayaka Satoh ◽  
Hiroki Tani ◽  
Kouichi Mandai ◽  
Takao Masaki
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tubulointerstitial Nephritis ◽  
Basement Membranes ◽  
High Dose ◽  
Close Monitoring ◽  
Acute Tubulointerstitial Nephritis ◽  
Igm Deposits

Abstract Nivolumab is an anti-programmed cell death-1 antibody that is utilized as an immune checkpoint inhibitor for several malignancies. However, this agent is associated with immune-related adverse events (irAEs), mainly in the spectrum of autoimmune disease including interstitial pneumonia, colitis, type 1 diabetes, and renal impairment. We herein present the case of a 59-year-old man with renal cell carcinoma who developed worsening renal function approximately 4 months after initiation of nivolumab. Urinalysis showed proteinuria and microscopic hematuria along with increase levels of N-acetyl-β-d-glucosaminidase. Renal biopsy revealed acute tubulointerstitial nephritis and thickening of the glomerular basement membranes. Immunofluorescence showed granular IgM deposits in capillary loops. We initiated high-dose prednisolone therapy with nivolumab, which improved renal function and achieved complete remission of proteinuria. Although renal irAEs are considered to be rare and glomerulonephropathy is not typical presentation, physicians need the close monitoring of renal function and urinalysis in patients under immunotherapy with this agents. In addition, our case provides a possible link between nivolumab and immune-mediated glomerulonephropathy.

scholarly journals Preeclampsia, HELLP Syndrome, and Postpartum Renal Failure with Thin Basement Membrane Nephropathy: Case Report and a Brief Review of Postpartum Renal Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
K. C. Janga ◽  
Pavani Chitamanni ◽  
Shraddha Raghavan ◽  
Kamlesh Kumar ◽  
Sheldon Greenberg ◽  
...  
Keyword(s):  
Renal Failure ◽  
Basement Membrane ◽  
Renal Biopsy ◽  
Hellp Syndrome ◽  
Tubulointerstitial Nephritis ◽  
Laboratory Evaluation ◽  
High Dose ◽  
Acute Tubulointerstitial Nephritis ◽  
Thin Basement Membrane Nephropathy ◽  
First Case

A 36-year-old primigravida female from a birthing center was referred for elevated blood pressure to the hospital two days after normal spontaneous vaginal delivery with nausea, vomiting, and diarrhea. During this two-day period, she was experiencing persistent vaginal bleeding and lower abdominal pains for which she took six doses of 600 mg ibuprofen. Further laboratory evaluation reflected leukocytosis, anemia, thrombocytopenia, elevation of liver enzymes, and renal failure with hyperkalemia requiring emergent hemodialysis once in the Medical Intensive Care Unit (MICU). She was diagnosed with HELLP syndrome with underlying preeclampsia. A week later, due to hypertension controlled with medications and nonoliguric renal failure with no active urine sediments, a renal biopsy was indicated to direct management. The renal biopsy supported the diagnosis of diffuse severe acute tubulointerstitial nephritis with hypereosinophilia and thin basement membrane nephropathy (see figures). She was subsequently treated with high-dose steroids which resulted in the normalization of blood pressures and renal function returning to baseline. We report the first case of acute tubulointerstitial nephritis in an individual with thin basement membrane nephropathy secondary to postpartum complications.

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