[A case of granulomatous interstitial nephritis presented reversible renal failure treated with the steroid therapy: repeated renal biopsy case].
This report describes clinical and histopathological findings of a case of a 43-year-old male with granulomatous interstitial nephritis. The patient developed renal failure following renal insufficiency of 4 months duration. The patient presented with lethargy and nocturia. The first renal biopsy revealed granulomatous interstitial nephritis. There was no apparent evidence of a systemic granulomatous disease or drug hypersensitivity. Therapy with reducing regime of prednisolone produced a marked improvement in symptoms and renal function. Relapse occurred 3 months later in association with early discontinuation of the corticosteroid therapy. Ga-scintigraphy demonstrated an abnormal accumulation of gallium in both kidneys. The second renal biopsy did not show the obvious improvement. With the re-administration of the corticosteroid therapy, renal function rapidly improved again. Twelve months after the re-administration of the steroid therapy, Ga-scintigraphy showed no renal uptake. Corticosteroid therapy yielded a favorable outcome for renal function. The third renal biopsy showed disappearance of the granulomas lesion. Re-administration of the corticosteroid therapy continued for 22 months and the patient has not yet relapsed 9 months after the withdrawal of the steroid therapy.
Uchida
T
T
Department of Internal Medicine, Yokohama Dai-ichi Hospital, Kanagawa, Japan.
Takebayashi
S
S
Shimoyama
K
K
Misugi
K
K
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D001706:Biopsy; D006099:Granuloma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D009395:Nephritis, Interstitial / Q000188:drug therapy* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*
D011239:Prednisolone