The clinical spectrum of tubulointerstitial nephritis

Rastegar, Asghar; Kashgarian, Michael

doi:10.1046/j.1523-1755.1998.00001.x

Cited by 71 publications

(40 citation statements)

References 101 publications

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“…Analysis of the urine can show differing degrees of proteinuria, whether associated with pyuria and haematuria or not [6,7,18]. In our case, the patient had no signi icant urinary alterations beyond gross haematuria hours after the introduction of the bladder catheter and, persistence of microscopic haematuria without dysmorphic erythrocytes during his hospitalization -even after removal of the bladder catheter and performed an abdominal ultrasound without abnormal indings.…”

Section: Discussionmentioning

confidence: 48%

“…ATIN resulting from the use of medication is probably immunologically mediated and idiosyncratic in nature [6]. Several patients make use of drugs that could potentially lead to ATIN, but only a small percentage of these patients actually develop the disease-some of these individuals, however, also show other extra-renal signs of hypersensitivity and the effects are not dose-dependent [22].…”

Section: Discussionmentioning

confidence: 99%

“…The classical clinical presentation of cases of ATIN includes the following key signs and symptoms: fever, skin rash, eosinophilia, and non-oliguric kidney failure, together with tubular dysfunction and abnormalities in the urinary sediment [4]. However, most cases proceed with non-speci ic symptoms, only followed by insidious deterioration of kidney function [6][7][8]. Probable causes include therapy based on medication; infection; and self-immune diseases [8].…”

Section: Introductionmentioning

confidence: 99%

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Acute Tubulointerstitial Nephritis due to Phenytoin: Case Report

Bresolin¹

2017

J Clini Nephrol

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SUMMARYIntroduction: Acute tubulointerstitial nephritis (ATIN) is an acute kidney injury (AKI) resulting from damage to the tubulointerstitial tissue due to infection, trauma, or use of medication. It is clinically non-specifi c.Case: A teenager with multiple trauma, hospitalised after lowering of level of conscience, and convulsion fi ts. While in the emergency ward, he received: midazolam, fentanyl and phenytoin. The cranial and abdominal CT scans were normal. He was stable with no signs of shock, trauma or infection; he developed oliguria and serum creatinine (Scr) 1.7mg/dL), 12 hours after the admission. After 36 hours, Scr levels were at 3.4mg/dL and urea at 55mg/dL. He had AKI according to pRIFLE (66.2% reduction in clearance). After other causes of AKI had been ruled out, the possibility of ATIN was raised; the phenytoin was suspended and pulse therapy, with methylprednisolone, was promptly initiated. After the fi rst pulse, there was already a decline in the creatinine and urea readings; 48 hours later: Scr at 2.2mg/dL and urea at 86mg/dL. Thirty days after being discharged from hospital, the patient was in good health and had full restoration of kidney function. Discussion:The singularity of this report relies on the rarity of ATIN secondary to the use of phenytoin and also in the importance of recognizing this aetiology as being one of the origins of AKI. Conclusion:Early diagnosis allows the reversal of AKI through suppression of treatment with phenytoin and introduction of corticosteroid therapy, when necessary.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Tubulointerstitial Nephritis due to Phenytoin: Case Report

Bresolin¹

2017

J Clini Nephrol

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“…Seperti diketahui bahwa kompartemen tubulointerstisialis bukan hanya struktur penyokong nefron, tetapi juga melakukan tempat terjadinya transport cairan dan elektrolit. 7 …”

Section: Pembahasanunclassified

“…Pada anak tidak banyak laporan tentang NTI, khususnya NTI kronik. Hal tersebut disebabkan tanda dan gejala NTI tidak spesifik, [1][2][3][4][5][6][7] sehingga NTI sering kali baru diketahui setelah dilakukan biopsi. Di Indonesia belum ada laporan mengenai NTI pada anak.…”

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Nefritis Tubulointerstisialis pada Kasus Anak yang Menjalani Biopsi Ginjal

Lestari

Trihono

2016

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Latar belakang. Nefritis tubulointerstisialis (NTI) adalah sindrom yang merupakan spektrum penyakit akutdan kronik, yang secara histologis ditandai oleh inflamasi dan kerusakan struktur tubulus dan interstisial,dengan sedikit pengaruh pada elemen glomerular dan vaskular. Diagnosis pasti ditegakkan berdasarkanbiopsi ginjal, karena tidak ada pemeriksaan klinis dan penunjang non invasif yang spesifik dan sensitif.Tujuan. Mengetahui gambaran histopatologi yang menunjukkan keterlibatan tubulointerstisialis sertahubungannya dengan gambaran klinis dan laboratorium pada kasus anak usia kurang dari 18 tahun yangmenjalani biopsi ginjal pada periode 2005-2009.Metode. Penelitian retrospektif deskriptif dengan sumber data sekunder rekam medik Departemen IlmuKesehatan Anak dan Departemen Patologi Anatomi Fakultas Kedokteran Universitas Indonesia – RS Dr.Cipto Mangunkusumo Jakarta.Hasil. Terdapat 45 kasus anak yang menjalani biopsi ginjal, terdiri dari 24 orang laki-laki dan 21 perempuanyang berusia 6 bulan sampai 16 tahun. Indikasi biopsi adalah glomerulonefritis akut, sindrom nefrotik,nefritis lupus, dan tumor ginjal. Gambaran klinis yang ditemukan yaitu edema, hipertensi, oliguria, demam,pucat, dan muntah. Gambaran laboratorium yaitu peningkatan kreatinin, asidosis metabolik, hipokalemia,proteinuria, hematuria, dan leukosituria steril. Gambaran nefritis tubulointerstisialis adalah infiltrasi selradang kronik, atrofi tubulus, fibrosis interstisialis, dan edema interstisialis. Beberapa gejala yang lebihbanyak terjadi pada pasien dengan lebih atau sama dengan satu kelainan tubulointerstisialis yaitu demam(p<0,05), anemia, muntah, dan asidosis metabolik.Kesimpulan. Nefritis tubulointerstisialis sebagai suatu entitas diagnosis cukup banyak ditemukan dan perludiberikan lebih banyak perhatian, dalam upaya menurunkan morbiditas dan mortalitas dari penyakit ginjalpada anak.

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