We present the case of a teenage boy with Crohn’s disease treated with adalimumab who presented with discrete renal masses, found while undergoing evaluation for elevated creatinine and hypocalcemia. The MRI result, as well as the potential increased risk of malignancy in patients treated with TNF-blockers, both contributed to primary concerns of malignancy in this case. Pathology was consistent, however, with IN and not malignancy. The radiographic presentation of the IN in this case was very unusual, as IN can present as a striated nephrogram on imaging, but has not been described as discrete masses. We are not aware of any other cases of IN reported appearing this way on imaging.
Granulomatous Interstitial Nephritis in Children Resulting from Wegener’s Granulomatosis, Crohn’s Disease, or Sarcoidosis