1/31. Acute eosinophilic interstitial nephritis and uveitis (TINU syndrome) associated with granulomatous hepatitis.A 23-year-old male presented with renal failure, cholestatic liver enzyme elevation and uveitis. Percutaneous renal biopsy revealed marked eosinophilic infiltration of the renal interstitium, which made the diagnosis of TINU syndrome (Tubulo-Interstitial Nephritis and uveitis). Percutaneous liver biopsy showed granulomatous hepatitis, which was not described as a part of TINU syndrome. The diagnostic dilemma and the literature are discussed.- - - - - - - - - - ranking = 1keywords = nephritis (Clic here for more details about this article) |
2/31. Eosinophilic tubulo-interstitial nephritis associated with iridocyclitis and thyreoiditis.A patient is described with the tubulointerstitial nephritis with uveitis syndrome. The diagnosis can be difficult since it has to be differentiated from sarcoidosis, or infections like tuberculosis and toxoplasmosis. Our patient showed prompt recovery of fever, ocular symptoms and renal function after starting corticosteroids.- - - - - - - - - - ranking = 1.25keywords = nephritis (Clic here for more details about this article) |
3/31. Interstitial nephritis, hepatic failure, and systemic eosinophilia after minocycline treatment.This report describes a 15-year-old white boy who presented with fever, back pain, a disseminated exanthematous rash, renal failure, and hepatopathy 3 weeks after the initiation of oral minocycline therapy for facial acne. Marked peripheral and urine eosinophilia were noted. A bone marrow aspiration showed more than 50% eosinophils without any evidence of malignancy, and a simultaneous kidney biopsy showed acute interstitial nephritis (AIN). The patient's symptoms and laboratory findings improved after high-dose steroid therapy was initiated, worsened when it was withheld, and improved again after it was reinitiated in view of the biopsy findings. The patient recovered completely, and steroids were tapered to discontinuation over 3 months. Over a year later, the patient's peripheral blood mononuclear cells (PBMCs) were cultured for 2 weeks in the presence or absence of minocycline ex vivo, and minocycline was found to induce the emergence of CD4( ) cells after 1 week in culture. In conclusion, this article shows for the first time several new aspects of minocycline-induced morbidity: renal and hepatic failure can occur together, and AIN and elevated blood eosinophil counts can be accompanied by marked bone marrow eosinophilia, suggesting a systemic allergic response as the underlying pathomechanism. Furthermore, the initial phase of such a response appears to involve CD4( ) T cells detectable ex vivo. Lastly, high-dose treatment with corticosteroids appears to be beneficial in this setting.- - - - - - - - - - ranking = 1.25keywords = nephritis (Clic here for more details about this article) |
4/31. 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.- - - - - - - - - - ranking = 2keywords = nephritis (Clic here for more details about this article) |
5/31. Uncommon vancomycin-induced side effects.vancomycin has been used with increased frequency during the past 15 years and the most common toxicity with this drug is the red man syndrome . Other adverse effects include neutropenia, fever, phlebitis, nephrotoxicity, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear iga bullous dermatosis, necrotizing cutaneous vasculitis and toxic epidermal necrolysis. Only two cases of vancomycin-induced stevens-johnson syndrome and one case of pancytopenia have been reported in the medical literature. The treatment for both situations is based on cessation of the vancomycin therapy; in cases of stevens-johnson syndrome, antihistamine and/or steroid agents can be used. This article reports a case of pancytopenia and a case of erythema major associated with neutropenia.- - - - - - - - - - ranking = 0.25keywords = nephritis (Clic here for more details about this article) |
6/31. Atypical presentation of churg-strauss syndrome: another "forme fruste" of the disease?vasculitis is a clinicopathologic process characterized by inflammation and damage to blood vessels. A broad and heterogenous group of syndromes may result from this process, because any type, size, and location of blood vessel may be involved. The cause of these conditions remains unclear, but an autoimmune inflammatory process, characterized by involvement of both neutrophils and endothelial cells, seems to play an important role. In 1951, Churg and Strauss described a clinical syndrome of severe asthma, hypereosinophilia with eosinophilic infiltrates, eosinophilic vasculitis, and granulomata in various organs. asthma may precede this vasculitis by many years. We report a case of anti-neutrophil cytoplasmic antibody-positive, pauci-immune, crescentic, necrotizing glomerulonephritis with peripheral and interstitial eosinophilia but without asthma. This is very unusual in churg-strauss syndrome.- - - - - - - - - - ranking = 0.25keywords = nephritis (Clic here for more details about this article) |
7/31. A limited form of churg-strauss syndrome presenting without asthma and eosinophilia.We report a young woman presenting with digital gangrene, paranasal sinusitis, mononeuritis multiplex, and rapidly progressive glomerulonephritis without asthma and eosinophilia - an extremely rare variant of this disease.- - - - - - - - - - ranking = 0.25keywords = nephritis (Clic here for more details about this article) |
8/31. vancomycin-induced hypersensitivity reaction with acute renal failure: resolution following cyclosporine treatment.Drug rash with eosinophilia and systemic symptoms or DRESS syndrome is a distinct severe drug-induced hypersensitivity reaction characterized by skin rash, fever, eosinophilia and visceral involvement. The latter leads to a 10% mortality rate, with interstitial nephritis occurring in about 10% of the cases. The outcome is usually favorable after withdrawal of drug therapy; systemic corticosteroid therapy may hasten the recovery, although there are no data from prospective, randomized trials evaluating the efficacy of this approach. Administration of other immunosuppressive agents (cyclophosphamide, cyclosporine) has also been suggested. We report on a patient with vancomycin-induced DRESS syndrome with acute interstitial nephritis and hepatitis. There was no improvement after withdrawal of the offending agent and empiric corticosteroid use. After tapering the steroids, a five-day course of cyclosporine was followed by quick resolution of the skin rash and recovery of renal function. cyclosporine could represent a treatment option in cases of severe visceral involvement such as persistent renal insufficiency that do not improve after discontinuation of the offending agent and administration of high doses of steroids.- - - - - - - - - - ranking = 0.5keywords = nephritis (Clic here for more details about this article) |
9/31. Allergic nephropathy associated with ciprofloxacin.We report a case of ciprofloxacin-related allergic tubulointerstitial nephritis, which manifested as nonoliguric renal failure, eosinophilia, and eosinophiluria. Our patient responded to discontinuation of ciprofloxacin therapy and oral administration of a brief course of corticosteroids. Although rare, allergic tubulointerstitial nephritis apparently can be caused by ciprofloxacin therapy. Clinicians should be aware of this entity.- - - - - - - - - - ranking = 0.5keywords = nephritis (Clic here for more details about this article) |
10/31. hypersensitivity to salicylazosulfapyridine: renal and hepatic toxic reactions.Salicylazosulfapyridine has been used for a number of years as therapy for ulcerative colitis. Reported toxicities are usually minor. This case report represents an acute allergic reaction to the drug. Characterized by fever, rash, eosinophilia, nephritis, and hepatitis. Resolution occurred with discontinuation of salicylazosulfapyridine. Although similar reactions have been reported with the antimicrobial sulfonamides, none has been fully described with salicylazosulfapyridine, a combination of a sulfonamide and salicylate.- - - - - - - - - - ranking = 0.25keywords = nephritis (Clic here for more details about this article) |
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