scholarly journals MP079TWO CASES OF ACUTE KIDNEY INJURY WITH KARYOMEGALIC INTERSTITIAL NEPHRITIS AFTER NIVOLUMAB TREATMENT

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii454-iii454
Author(s):  
Masaki Ryuzaki ◽  
Hirobumi Tokuyama ◽  
Kiyotaka Uchiyama ◽  
Hideaki Nakaya ◽  
Kazuhiro Hasegawa ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Injury

scholarly journals Granulomatous interstitial nephritis in a patient with SARS-CoV-2 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Szajek ◽  
Marie-Elisabeth Kajdi ◽  
Valerie A. Luyckx ◽  
Thomas Hans Fehr ◽  
Ariana Gaspert ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Case Reports ◽  
Kidney Injury ◽  
Maculopapular Rash ◽  
Tubular Injury ◽  
Granulomatous Interstitial Nephritis ◽  
First Case

Abstract Background Acute kidney injury (AKI) associated with severe coronavirus disease 19 (COVID-19) is common and is a significant predictor of morbidity and mortality, especially when dialysis is required. Case reports and autopsy series have revealed that most patients with COVID-19 – associated acute kidney injury have evidence of acute tubular injury and necrosis - not unexpected in critically ill patients. Others have been found to have collapsing glomerulopathy, thrombotic microangiopathy and diverse underlying kidney diseases. A primary kidney pathology related to COVID-19 has not yet emerged. Thus far direct infection of the kidney, or its impact on clinical disease remains controversial. The management of AKI is currently supportive. Case Presentation The patient presented here was positive for SARS-CoV-2, had severe acute respiratory distress syndrome and multi-organ failure. Within days of admission to the intensive care unit he developed oliguric acute kidney failure requiring dialysis. Acute kidney injury developed in the setting of hemodynamic instability, sepsis and a maculopapular rash. Over the ensuing days the patient also developed transfusion-requiring severe hemolysis which was Coombs negative. Schistocytes were present on the peripheral smear. Given the broad differential diagnoses for acute kidney injury, a kidney biopsy was performed and revealed granulomatous tubulo-interstitial nephritis with some acute tubular injury. Based on the biopsy findings, a decision was taken to adjust medications and initiate corticosteroids for presumed medication-induced interstitial nephritis, hemolysis and maculo-papular rash. The kidney function and hemolysis improved over the subsequent days and the patient was discharged to a rehabilitation facility, no-longer required dialysis. Conclusions Acute kidney injury in patients with severe COVID-19 may have multiple causes. We present the first case of granulomatous interstitial nephritis in a patient with COVID-19. Drug-reactions may be more frequent than currently recognized in COVID-19 and are potentially reversible. The kidney biopsy findings in this case led to a change in therapy, which was associated with subsequent patient improvement. Kidney biopsy may therefore have significant value in pulling together a clinical diagnosis, and may impact outcome if a treatable cause is identified.

scholarly journals Nitrofurantoin-Associated Acute Granulomatous Interstitial Nephritis

2021 ◽  
Vol 9 ◽  
pp. 232470962110016
Author(s):  
B. K. Anupama ◽  
Parth Sampat ◽  
Harvir S. Gambhir
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Case Report ◽  
Interstitial Nephritis ◽  
Visual Hallucination ◽  
Kidney Injury ◽  
Corticosteroid Administration ◽  
Granulomatous Interstitial Nephritis ◽  
Rare Association ◽  
New Onset

We report the case of a 71-year-old female who was incidentally found to have nonoliguric acute kidney injury on a routine workup for new-onset visual hallucination. Further history revealed inadvertent usage of nitrofurantoin for 3 months for an anticipated urological procedure. Renal biopsy demonstrated acute granulomatous interstitial nephritis. The renal function significantly improved following discontinuation of nitrofurantoin and corticosteroid administration. We highlight a rare association of nitrofurantoin with acute granulomatous interstitial nephritis through this case report.

scholarly journals Rifampicin Induced Acute Interstitial Nephritis in a Patient with Tubercular Lymphadenitis: A Case Report

2018 ◽  
Vol 8 (3) ◽  
pp. 257-259
Author(s):  
Hafsa Hassan Khan ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
Tufayel Ahmed Chowdhury ◽  
Sarwar Iqbal
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Adverse Effects ◽  
Interstitial Nephritis ◽  
Case History ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
History Of ◽  
Tubercular Lymphadenitis ◽  
Prompt Diagnosis

Rifampicin is one of the most effective anti-tubercular agents. Among its rare adverse effects, acute interstitial nephritis (AIN) is noteworthy. Here, we describe the case history of a 55-year-old female with tubercular lymphadenitis who developed rifampicin induced AIN upon re-exposure and recovered satisfactorily without requiring steroids. Rifampicin induced AIN should be kept in mind when patients present with acute kidney injury as prompt diagnosis and discontinuation of the drug has excellent prognosis.Birdem Med J 2018; 8(3): 257-259

scholarly journals Time to Acute Kidney Injury in β-Lactam−Induced Acute Interstitial Nephritis

2020 ◽  
Vol 5 (7) ◽  
pp. 1068-1070 ◽  
Author(s):  
Benjamin Lazarus ◽  
Matthew R.P. Davies ◽  
Jason A. Trubiano ◽  
Rebecca Pellicano
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis

scholarly journals SP225OUTCOMES OF INTERSTITIAL NEPHRITIS TREATMENT FROM A DEDICATED ACUTE KIDNEY INJURY CLINIC

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii179-iii180 ◽  
Author(s):  
Mustakim Khandaker ◽  
Rebecca Brown
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Injury

scholarly journals A case of acute kidney injury caused by granulomatous interstitial nephritis associated with sarcoidosis

2017 ◽  
Vol 7 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Taro Horino ◽  
Tatsuki Matsumoto ◽  
Kosuke Inoue ◽  
Osamu Ichii ◽  
Yoshio Terada
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Injury ◽  
Granulomatous Interstitial Nephritis

scholarly journals Acute interstitial nephritis with immunotherapy; a growing entity?

2020 ◽  
Vol 9 (4) ◽  
pp. e35-e35
Author(s):  
John David Chetwood ◽  
Lin Lin Myat ◽  
Helen Lammi ◽  
Mani Panat ◽  
James Hughes
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Interstitial Nephritis ◽  
Cancer Survival ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Response To Treatment ◽  
Immune Mediated ◽  
Life Threatening ◽  
Potential Impact

We report a case of acute kidney injury (AKI) secondary to immune-mediated acute interstitial nephritis (AIN), with supporting diagnostic results and a successful response to treatment. This entity is gaining increasing recognition with the burgeoning use of immunotherapy agents in oncology. The timeline for the development of AIN from the initiation of immunotherapy varies, and may range in severity from asymptomatic to severe, organ-threatening and with life threatening consequences. Renal biopsy should be performed to confirm the diagnosis due to the potential impact of discontinuation of immunotherapy on cancer survival. Re-challenge with immunotherapy is reasonable once renal function recovers.

Acute interstitial nephritis: New agents for an old entity

2020 ◽  
Vol 4 (3) ◽  
pp. 100-104
Author(s):  
Filipa Cardoso ◽  
Rui Barata ◽  
David Navarro ◽  
Marco Mendes ◽  
Mário Góis ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Protein Kinase ◽  
Kidney Function ◽  
Interstitial Nephritis ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Mitogen Activated Protein Kinase ◽  
Dermatologic Toxicity ◽  
Mitogen Activated Protein ◽  
Protein Kinase Kinase

A 73-year-old male diagnosed with metastasized malignant melanoma was started on combined therapy with dabrafenib and trametinib, but soon admitted with gastrointestinal intolerance. Blood tests revealed toxic hepatitis and acute kidney injury. Renal duplex Doppler ultrasound ruled out urinary and vascular obstruction and apart from a positive antinuclear antibody, other tests for acute kidney injury assessment were unremarkable. Urinary sediment microscopy showed dysmorphic red blood cells, in addition to yellow-pigmented casts. Kidney biopsy revealed signs of acute tubular necrosis and acute interstitial nephritis. Kidney function declined further, prompting the need for urgent hemodialysis. Treatment with dabrafenib and trametinib was stopped and corticosteroids were initiated, with a rapid beneficial effect on both the kidney function and liver toxicity. Hemodialysis was stopped after four sessions with a full recovery after 2 months of corticosteroids, with the dose being slowly tapered. Unfortunately, the patient died a few months later due to melanoma progression. Dual therapy with the combination of a B-Raf proto-oncogene inhibitor with a mitogen-activated protein kinase kinase inhibitor improves response rates and has been recently approved by the U.S. Food and Drug Administration, and while dermatologic toxicity is a common adverse effect, the association with acute renal failure has seldom been reported. To the best of our knowledge, there are only two published case reports of acute kidney injury in patients treated with combination of dabrafenib and trametinib and only one of them is biopsy proven. Further studies evaluating the incidence of acute kidney injury with the combination of B-Raf proto-oncogene and mitogen-activated protein kinase kinase inhibitors are warranted, and may provide new insights into the mechanisms underlying renal toxicity.

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