Tubulointerstitial nephritis with anti-neutrophil cytoplasmic antibody following indomethacin treatment.

Sir, Tubulointerstitial diseases including tubulointerstitial nephritis (TIN) have an impact on overall renal function and eventual prognosis of renal diseases [1]. However, the detailed pathogenesis of human TIN has not been fully studied. Renal involvement in anti-neutrophil cytoplasmic antibody (ANCA)-associated diseases shows mainly glomerular lesion, especially necrotizing crescentic glomerulonephritis [2]. However, TIN with minor glomerular lesion in ANCA-associated diseases is rare. We herein describe a case showing TIN following indomethacin treatment and developed interstitial pneumonitis and pulmonary haemorrhage associated with high levels of myeloperoxidase (MPO)-ANCA.