Allergic Interstitial Nephritis Manifesting as a Striated Nephrogram
نویسندگان
چکیده
Allergic interstitial nephritis (AIN) is an underdiagnosed cause of acute kidney injury (AKI). Guidelines suggest that AIN should be suspected in a patient who presents with an elevated serum creatinine and a urinalysis that shows white cells, white cell casts, or eosinophiluria. Drug-induced AIN is suspected if AKI is temporally related to the initiation of a new drug. However, patients with bland sediment and normal urinalysis can also have AIN. Currently, a definitive diagnosis of AIN is made by renal biopsy which is invasive and fraught with risks such as bleeding, infection, and hematoma. Additionally, it is frequently unclear when a kidney biopsy should be undertaken. We describe a biopsy proven case of allergic interstitial nephritis which manifested on contrast enhanced Magnetic Resonance Imaging (MRI) as a striated nephrogram. Newer and more stable macrocyclic gadolinium contrast agents have a well-demonstrated safety profile. Additionally, in the presentation of AKI, gadolinium contrast agents are safe to administer in patients who demonstrate good urine output and a downtrending creatinine. We propose that the differential for a striated nephrogram may include AIN. In cases in which the suspicion for AIN is high, this diagnostic consideration may be further characterized by contrast enhanced MRI.
منابع مشابه
Diagnosis and Management of Acute Interstitial Nephritis - American Family Physician
www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 2527 stitium. The term was first used by Councilman in 1898 when he noted the histopathologic changes in autopsy specimens of patients with diphtheria and scarlet fever. Although the term acute interstitial nephritis is more commonly used, acute tubulointerstitial nephritis more accurately describes this disease entity, because the renal tubules, as we...
متن کاملمعرفی یک مورد سندرم نفریت اینترستیشیال حاد و یووئیتیس
Concurrence of interstitial nephritis and uveitis named tubulointestitioal nephritis and uveitis syndrome (TINU) are unusual and uncommon presentations of interstitial nephritis. This syndrome is considered after ruling out other differential diagnoses. A-38-year old man presented with acute renal failure and uveitis. The histologic findings of renal biopsy showed acute tubulointestitioal nephr...
متن کاملDrug-induced interstitial nephritis in a 9-year-old child: A case report
Drug-induced acute interstitial nephritis (DI-AIN) is a common cause of AKI and leading to CKD and ESRD Although any drug can potentially cause DI-AIN, antibiotics, non-steroidal anti-inflammatory drugs and proton pump inhibitors are the most common culprits. In the present study, we report a 9-year-old child with drug-induced interstitial nephritis (cefotaxime, vancomycin, and acyclovir). it s...
متن کاملFluoroquinolone-induced renal failure.
Fluoroquinolones are generally well tolerated, clinically useful antimicrobials. This paper highlights rare, but potentially serious, adverse effects involving the kidney. Other antimicrobials have long been known to cause various forms of nephrotoxicity occurring as allergic interstitial nephritis, granulomatous interstitial nephritis, necrotising vasculitis, allergic tubular nephritis or a tu...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 2015 شماره
صفحات -
تاریخ انتشار 2015