scholarly journals Acute interstitial nephritis and drug-induced systemic lupus erythematosus due to chlorthalidone and amiodarone: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091002 ◽  
Author(s):  
Umut Selamet ◽  
Ramy M Hanna ◽  
Anthony Sisk ◽  
Lama Abdelnour ◽  
Lena Ghobry ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Interstitial Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Systemic Manifestations

Drug-induced lupus erythematosus has features distinct from primary systemic lupus erythematosus. It can occur with a wide variety of agents that result in the generation of anti-histone or other types of antibodies. Systemic manifestations of drug-induced systemic lupus erythematosus may include renal dysfunction due to circulating immune complexes or due to other immune reactions to the culprit medication(s). Acute interstitial nephritis occurs due to DNA–drug or protein–drug complexes that trigger an allergic immune response. We report a patient who developed acute kidney injury, rash, and drug-induced systemic lupus diagnosed by serologies after starting chlorthalidone and amiodarone. A renal biopsy showed acute interstitial nephritis and not lupus-induced glomerulonephritis. It is important to note that systemic lupus erythematosus and acute interstitial nephritis can occur together, and this report highlights the role of the kidney biopsy in ascertaining the pathological diagnosis and outlining therapy in drug-induced lupus erythematosus.

Acute interstitial nephritis

2010 ◽  
pp. 4003-4005
Author(s):  
Simon D Roger
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Function ◽  
Interstitial Nephritis ◽  
Proton Pump ◽  
Lupus Erythematosus ◽  
Acute Interstitial Nephritis ◽  
Sudden Onset ◽  
Rapid Decline ◽  
Systemic Lupus ◽  
Inflammatory Drugs

Acute interstitial nephritis (AIN) is inflammation of the tubules and interstitium within the kidney, associated with a relatively sudden onset and a rapid decline in renal function. It is usually secondary to drugs [antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and proton pump inhibitors being most commonly incriminated], with other causes being infections (classically streptococcal, but this is now less common) and immune disorders (systemic lupus erythematosus, sarcoidosis, and tubulointerstitial nephritis with uveitis)....

scholarly journals RENAL DISEASE IN SYSTEMIC LUPUS ERYTHEMATOUS: ALL THAT GLITTERS IS NOT GOLD

2022 ◽  
Vol 71 (6) ◽  
pp. 2249-50
Author(s):  
Hafiz Waleed Khan ◽  
Abdul Rehman Arshad ◽  
Abdul Wahab Mir
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Past History ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Oral Prednisolone ◽  
Acute Interstitial Nephritis ◽  
Underlying Disease ◽  
Valvular Regurgitation ◽  
Systemic Lupus

Patients with systemic lupus erythematosus may occasionally develop renal pathology from causes unrelated to the underlying disease. We describe one such case. This 22-year-old lady, with past history of arthritis, presented with dyspnea and fever. She had clinical signs consistent with systemic lupus erythematosus. Echocardiogram revealed valvular regurgitation. Antibiotics were started for probable infective endocarditis. She developed acute kidney injury. This was initially attributed to lupus nephritis, but subsequently renal histopathology revealed acute interstitial nephritis. Renal functions normalized with oral prednisolone. This case highlights the fact that a broader differential diagnosis must always be considered even if the diagnosis is clear.

Acute interstitial nephritis

2020 ◽  
pp. 4951-4956
Author(s):  
Simon D. Roger
Keyword(s):  
Renal Function ◽  
Interstitial Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Sudden Onset ◽  
Rapid Decline ◽  
Drug Induced ◽  
Chronic Renal Impairment ◽  
Loin Pain

Acute interstitial nephritis (AIN) is an inflammation of the tubules and interstitium within the kidney, associated with a relatively sudden onset and rapid decline in renal function. It is usually secondary to drugs (antibiotics, nonsteroidal anti-inflammatory drugs, and proton pump inhibitors being most commonly incriminated), with other causes being infections (classically streptococcal, but this is now less common) and immune disorders (systemic lupus erythematosus, sarcoidosis, and tubulointerstitial nephritis with uveitis). Clinical features—the diagnosis of AIN should be considered in any patient with unexplained acute kidney injury. Drug-induced AIN may present with a classic allergic response, including arthralgias, fever, rash, loin pain, and eosinophilia/eosinophiluria, but these are not invariable and their absence does not exclude the diagnosis. The urine typically shows low-grade proteinuria (<1 g/day). Renal biopsy is the only way to confirm or exclude the diagnosis. Management and prognosis—treatment is by ceasing the offending agent, treating the concurrent infectious cause, or managing the immune aetiology with steroids (typically prednisolone 1 mg/kg per day, tapered to zero over 6–8 weeks). Most patients with drug-induced AIN recover renal function, but some are left with chronic renal impairment and a small proportion progress to endstage chronic kidney disease.

The role of microRNAs (MiR-125a and MiR-146a), RANTES, and IFN-γin systemic lupus erythematosus

2020 ◽  
Vol 23 (13) ◽  
Author(s):  
Ikram khazal Qasim Al- hasso ◽  
Aida Rashid Al- Derzi ◽  
Ahmed Abdul-hassan Abbas ◽  
Faiq I. Gorial ◽  
Ahmed Sameer Alnuimi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus

scholarly journals Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

2019 ◽  
Vol 12 (12) ◽  
pp. e233446
Author(s):  
Kevin John ◽  
Krupa Varughese ◽  
Ranil Johann Boaz ◽  
Tarun George
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Lupus Erythematosus ◽  
Kidney Injury ◽  
Systemic Lupus ◽  
Uncommon Presentation ◽  
Acute Dyspnoea ◽  
Chronic Fever

A 42-year-old woman presented with chronic fever, abdominal pain, intermittent loose stools and dysuria for 3 months. She had recently developed acute dyspnoea with acute kidney injury. She was found to have a contracted, thick-walled bladder with bilateral hydroureteronephrosis. She underwent bilateral percutaneous nephrostomies, following which her renal function recovered. She satisfied the clinical and immunological features of the Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus (SLE). She was initiated on immunosuppression. Lupus cystitis with a contracted bladder is an uncommon presentation of SLE.

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