Acute interstitial nephritis: immunologic and clinical aspects.
Acute interstitial nephritis is a common renal syndrome that may be associated with a variety of infections and drug therapies or may develop without an identified cause. Three cases are presented to illustrate the three types of acute interstitial nephritis--drug related, infection related, and idiopathic. Cell-mediated immune mechanisms seem to be more important than humorally mediated mechanisms in the pathogenesis of acute interstitial nephritis. Frequently, eosinophils are identified as a component of the interstitial cellular infiltrate, and eosinophiluria and eosinophilia have been claimed to be helpful in the diagnosis of acute interstitial nephritis, especially the drug-induced type. Neither eosinophiluria nor the presence of increased urinary levels of eosinophil major basic protein, however, is specific for the diagnosis of acute interstitial nephritis. Patients with drug-induced interstitial nephritis frequently have symptoms and signs suggestive of a hypersensitivity syndrome and rarely have more dramatic anaphylactic manifestations. Systemic glucocorticoids have been shown to be beneficial in this type of acute interstitial nephritis.
D000208:Acute Disease; D000293:Adolescent; D000959:Antihypertensive Agents / Q000009:adverse effects; D001706:Biopsy; D004342:Drug Hypersensitivity / Q000150:complications*; D004802:Eosinophilia / Q000652:urine; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007111:Immunity, Cellular; D007239:Infections / Q000150:complications*; D007244:Infectious Mononucleosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000473:pathology
D000959:Antihypertensive Agents; D005938:Glucocorticoids