Granulomatous interstitial nephritis and Crohn's disease

Timmermans, Sjoerd A.M.E.G.; Christiaans, Maarten H. L.; Abdul‐Hamid, Myrurgia A.; Stifft, Frank; Damoiseaux, Jan; Paassen, Pieter van

doi:10.1093/ckj/sfw041

Cited by 18 publications

(9 citation statements)

References 16 publications

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“…Granulomatous interstitial nephritis can be a manifestation of systemic diseases, such as Wegener's granulomatosis, Crohn's disease [17], and sarcoidosis. Usually, renal damage in sarcoidosis is associated with nephrocalcinosis, hypercalciuria, or urolithiasis [4].…”

Section: Granulomatous Nephritis Resulted In Nephrosclerosismentioning

confidence: 99%

Granulomatous Interstitial Nephritis in Children Resulting from Wegener’s Granulomatosis, Crohn’s Disease, or Sarcoidosis

Makovetskaya¹,

Mazur²,

Balashova³

2020

Sarcoidosis and Granulomatosis - Diagnosis and Management

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Granulomatous interstitial nephritis (GIN) is a rare type of kidney disease, the precise etiology of which is obscure, but is most commonly seen following drug therapy and infection. The main infections seen in the onset of this pathology, especially in immunocompromised patients, include mycobacteria and fungi. Granulomatous interstitial nephritis can be a manifestation of systemic diseases, such as Wegener's granulomatosis, Crohn's disease, or sarcoidosis. We present our experience with GIN diagnosis and management.

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Section: Granulomatous Nephritis Resulted In Nephrosclerosismentioning

confidence: 99%

Granulomatous Interstitial Nephritis in Children Resulting from Wegener’s Granulomatosis, Crohn’s Disease, or Sarcoidosis

Makovetskaya¹,

Mazur²,

Balashova³

2020

Sarcoidosis and Granulomatosis - Diagnosis and Management

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“…Acute granulomatous interstitial nephritis is considered an uncommon pathological finding in renal biopsy (<1% of native renal biopsies) that has been associated with various etiologies, of which drug hypersensitivities and sarcoidosis encompass the majority of cases. 8 Ulcerative colitis is a chronic inflammatory disease with localization in the colon and rectum. The exact pathogenesis is not fully clarified but involves a dysregulation of the gastrointestinal immune system in patients with a genetic predisposition.…”

Section: Discussionmentioning

confidence: 99%

Acute granulomatous interstitial nephritis and ulcerative colitis: a case report and literature review

et al. 2018

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Tubulo-interstitial nephritis (TIN) in patients affected by inflammatory bowel disease, both ulcerative colitis and Crohn’s disease, is usually considered as drug-associated to aminosalicylate. We report a rare case of granulomatous active tubulo-interstitial nephritis in a young patient with a recent diagnosis of ulcerative colitis naïve to aminosalicylate treatment. The patient has been successfully treated with steroids administration. Our purpose is to sensitize that TIN should always to be considered in differential diagnosis an extra-intestinal manifestation of bowel disease.

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“…2 In fact, anti-tumor necrosis factor agents have been used to alleviate granulomatous interstitial nephritis in patients with Crohn's disease. 3 First-line treatment is glucocorticoids, and the patient was kept on golimumab and had 50 mg prednisolone. The treatment was ceased after 4 weeks owing to intolerance to side effects, and lack of improvements on estimated glomerular filtration rate levels.…”

Section: Answer To: Image 3 (Page 58): Crohn's Disease With Progressimentioning

confidence: 99%

Crohn’s Disease With Progressive Renal Impairment

2020

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Question: The patient was diagnosed with Crohn's disease of the colon at the age of 39 years and had a chronic active disease course with rapid response to infliximab. Biopsies from the colon showed extensive inflammation with granulomas. The patient had secondary loss of response to infliximab due to formation of antidrug antibodies (ADA). She did not tolerate azathioprine or 6-mercaptopurine owing to pancreatitis and had severe hair loss when treated with methotrexate. Owing to previous good response to anti-TNF treatment, the patient was given adalimumab and subsequently certolizumab pegol, both with good initial responses, but unfortunately with subsequent loss of response caused by ADA formation. The patient also had significant extraintestinal manifestations (iridocyclitis, sacroiliitis, and peripheral arthropathies) that tended to respond to biologics. At the age of 45, the patient was switched to golimumab with good symptomatic control of the disease and extraintestinal manifestations, but fluctuating Creactive protein levels between 0.5 and 2.5 mg/dL. At the age of 48, her estimated glomerular filtration rate decreased to <60 mL/min with more rapid decreases in periods with elevated inflammatory markers (Figure A). Urinalysis revealed proteinuria and no occult blood. Urinary excretion of protein was between 0.2 and 0.6 g/d. An initial ultrasound examination of the kidneys and urinary tracts was normal and a Tc-99-MAG3 renography showed bilateral decreased kidney function. A kidney biopsy was performed (Figure B). What is the diagnosis and treatment? Look on page 59 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and images in GI.

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Granulomatous interstitial nephritis and Crohn's disease

Cited by 18 publications

References 16 publications

Granulomatous Interstitial Nephritis in Children Resulting from Wegener’s Granulomatosis, Crohn’s Disease, or Sarcoidosis

Granulomatous Interstitial Nephritis in Children Resulting from Wegener’s Granulomatosis, Crohn’s Disease, or Sarcoidosis

Acute granulomatous interstitial nephritis and ulcerative colitis: a case report and literature review

Crohn’s Disease With Progressive Renal Impairment

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