A case of mesalazine-induced acute interstitial nephritis (AIN) in a 41-year-old patient with ulcerative colitis (UC) is reported here. Clinical symptoms such as fever and arthralgia, and laboratory findings such as eosinophilia and renal failure suggested AIN, which was confirmed by biopsy. With withdrawal of mesalazine and intravenous methylprednisolone the patient's renal function was recovered. It is observed that early discontinuation of mesalazine is associated with amelioration of interstitial nephritis in most patients, so the recommendation is that patients receiving mesalazine should undergo routine monitoring of renal function. Delayed diagnosis may lead to permanent renal function impairment.

PURPOSE: There is a paucity of epidemiological data on biopsy-proven renal disease in Croatia. The purpose of this report is a review of clinical and histological data, over a period of 15 years, from the single biggest adult native renal biopsy centre in Croatia.METHODS: This report includes data from 922 adult native renal biopsies in patients referred from the whole country and performed in our centre from 1996 till February 2012. Data on age, gender, serum creatinine, urine sediment, 24-hour proteinuria, clinical syndrome and histological diagnosis were collected and analyzed retrospectively. In all patients light, immunofluorescence and electron microscopic analysis was performed.RESULTS: The median age of the patients was 48 years (interquartile range 36-59 years), and the majority of patients were men (57.8%). The most common indication for renal biopsy was nephrotic syndrome (40.3%) followed by asymptomatic urinary abnormalities (31.7%). The most common biopsy-proven renal disease in total was IgA glomerulonephritis (19.3%), followed by FSGS (15.8%) and membranous glomerulonephritis (9.2%). In men similar results were found, while in women the most common were hereditary nephritis (13.4%), FSGS (12.9%) and connective tissue disease-related glomerular disorders (11.6%).CONCLUSION: The presented data are an important contribution to the better understanding of the epidemiology of biopsy-proven renal disease in Croatia and Europe throughout comparison with other registry data. This data should be the basis for the formation of Croatian Registry of Renal Biopsies.

Underlying malignancy has been thought to be responsible for 5–10% of the cases of membranous nephropathy in adults, with the risk being highest in patients over the age of 60 years. Solid tumors such as carcinomas of lung or colon, are most often involved. It is presumed that tumor antigens are deposited in the glomeruli; this is followed by antibody deposition and complement activation, leading to epithelial cell and basement membrane injury and proteinuria due to the associated increase in glomerular permeability. We describe a patient with a resistant nephrotic syndrome and massive proteinuria due to membranous nephropathy associated with pleural mesothelioma.

Središnja medicinska knjižnicaGalešić, K., Božić, B., Račić, I., Šćukanec-Špoljar, M.

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