scholarly journals A case of tubulointerstitial nephritis and uveitis syndrome after suspected drug-induced acute interstitial nephritis

2021 ◽  
Author(s):  
Yukiko Kitamura ◽  
shohei kuraoka ◽  
Koji Nagano ◽  
hiroshi tamura
Keyword(s):  
Interstitial Nephritis ◽  
Tubulointerstitial Nephritis ◽  
Late Onset ◽  
Acute Interstitial Nephritis ◽  
Suspected Drug ◽  
Drug Induced ◽  
Ophthalmic Examination ◽  
Tinu Syndrome ◽  
Eye Symptoms

Distinguishing between late-onset TINU syndrome and drug-induced AIN remains difficult given that patients with TINU syndrome may develop uveitis long after the onset of AIN. Therefore, ophthalmic examination is required not only upon diagnosis but also continuously or when eye symptoms, and relapse of urinary findings are observed.

scholarly journals Tubulointerstitial Nephritis and Uveitis Syndrome: Are Drugs Offenders or Bystanders?

2016 ◽  
Vol 9 ◽  
pp. CCRep.S36862 ◽  
Author(s):  
Mutsumi Kawamata ◽  
Tetsu Akimoto ◽  
Taro Sugase ◽  
Naoko Otani-Takei ◽  
Takuya Miki ◽  
...  
Keyword(s):  
Clinical Course ◽  
Tubulointerstitial Nephritis ◽  
Late Onset ◽  
Acute Interstitial Nephritis ◽  
Drug Induced ◽  
Histological Assessment ◽  
Tinu Syndrome ◽  
Ocular Manifestations ◽  
Renal Abnormalities

A 16-year-old female patient was admitted to our hospital due to progressive renal dysfunction with an increased serum creatinine (sCr) level of 1.7 mg/dL. Her clinical course without any ocular manifestations and results of drug-induced, lymphocyte-stimulating tests, in addition to a renal histological assessment, initially encouraged us to ascribe the patient's renal abnormalities to drug-induced acute interstitial nephritis (AIN). Four months later, she started to complain about reduced visual acuity when she was found to have anterior bilateral uveitis despite the recovered renal function with almost constant sCr levels around 0.7 mg/dL. Thus, a diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was finally made. Our case illustrates the difficulties in distinguishing late-onset uveitis TINU syndrome from drug-induced AIN at the time of the renal biopsy, thereby suggesting the importance of a longitudinal follow-up to overcome the potential underdiagnosis of the disease. Several diagnostic conundrums that emerged in this case are also discussed.

Tubulointerstitial Diseases

2017 ◽  
Author(s):  
Gerald B. Appel ◽  
Premila Bhat ◽  
Pietro Canetta
Keyword(s):  
Interstitial Nephritis ◽  
Tubulointerstitial Nephritis ◽  
Reflux Nephropathy ◽  
Acute Interstitial Nephritis ◽  
Clinical Findings ◽  
Obstructive Nephropathy ◽  
Physical Factors ◽  
Drug Induced ◽  
Analgesic Agents ◽  
Chronic Interstitial Nephritis

Tubulointerstitial diseases predominantly involve the tubules and the interstitium (the space between the tubules). They may be acute or chronic. Drug-induced acute interstitial nephritis (AIN) can be caused by antibiotics or nonsteroidal anti-inflammatory drugs. Drug-induced chronic interstitial nephritis can be caused by analgesic agents, lithium, antineoplastic agents, and cyclosporine. Physical factors causing interstitial damage are obstructive nephropathy, reflux nephropathy, and radiation nephritis. Discussions of infectious tubulointerstitial nephritis, metabolic and toxic tubulointerstitial nephritis, interstitial disease associated with vascular damage, tubulointerstitial disease caused by dysproteinemias and other tumors, and cystic disease of the kidney are also included. There are 13 figures, including micrographs, CT scans, pyelograms, and photographs of gross specimens, that illustrate the clinical findings of these diseases. Tables list the etiologies of tubulointerstitial diseases and drugs associated with AIN. This chapter has 161 references.

scholarly journals Tubulointerstitial Nephritis and Uveitis Syndrome—A Case Report and Review of Literature

2020 ◽  
Vol 5 (1) ◽  
pp. p27
Author(s):  
Hamzeh Mohammad Alrawashdeh, MD ◽  
Yazan Abu Gharbieh, MD ◽  
Omar Khalil Hamdan, MD ◽  
Mohammed Farah, MD
Keyword(s):  
Case Report ◽  
Interstitial Nephritis ◽  
Tubulointerstitial Nephritis ◽  
Pediatric Nephrology ◽  
Topical Steroid ◽  
Review Of Literature ◽  
Drug Induced ◽  
Tinu Syndrome ◽  
Rare Combination ◽  
History Of

A very little subset of patients diagnosed with interstitial nephritis have the tubulointerstitial nephritis and uveitis (TINU syndrome). A considerable number of cases have been documented in the pediatric nephrology and ophthalmology literature. We report a 12-year-old girl who presented with a history of allergic/drug-induced tubulointerstitial nephritis and diagnosed months later to have uveitis after stopping steroids. This considered a very rare combination and the diagnosis of tubulointerstitial nephritis and uveitis syndrome was established. She was treated successfully with topical steroid and topical cycloplegic agent for about 7 weeks. About 250 cases have been reported worldwide, and this is the first reported case in Jordan.

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.

scholarly journals Spontaneous Perinephric Urinoma Secondary to Drug Induced Acute Interstitial Nephritis: A Case Report

2021 ◽  
Author(s):  
Rajesh Kumar Varatharajaperumal ◽  
Rupa Renganathan ◽  
V Mangalakumar ◽  
Sriman Rajasekaran ◽  
Venkatesh Kasi Arunachalam
Keyword(s):  
Abdominal Pain ◽  
Interstitial Nephritis ◽  
Lower Abdominal Pain ◽  
Acute Interstitial Nephritis ◽  
Computed Tomography Scan ◽  
Drug Induced ◽  
Significant Deterioration ◽  
Loin Pain ◽  
Tomography Scan ◽  
Collecting System

AbstractUrinoma is defined as the extravasation of urine from any part of the urinary collecting system, which causes lipolysis of the surrounding fat, resulting in an encapsulated collection. The most common cause of urinoma is the direct obstruction of the urinary system. The other etiologies include trauma and postinstrumentation/surgery. Parenchymal cause for spontaneous urinoma is exceedingly rare. We present a case of a 30-year-old gentleman who presented with lower abdominal pain and was treated with a Diclofenac injection. The pain got better temporarily, but he presented again with right loin pain after 3 days. His computed tomography scan images revealed bilateral perinephric urinoma. As there was significant deterioration of renal function, he underwent a renal biopsy. The histopathology was reported as acute interstitial nephritis (AIN). Drug-induced AIN is very rarely presented with acute loin or abdominal pain due to spontaneous perinephric urinoma, as it was seen in our case.

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