Predominant tubulointerstitial lupus nephritis.
Predominant tubulointerstitial lupus nephritis is rare. Only eight cases have been described in the literature. We report the case of a 59-year-old man with systemic lupus erythematosus who presented with acute renal failure. On renal biopsy, he was found to have chronic tubulointerstitial nephritis with a mononuclear infiltrate. The immunofluorescence showed immune deposits in the tubular basement membranes, interstitium, and glomerular capsule. The glomeruli were minimally involved. He was initially treated with high-dose corticosteroids and supported with hemodialysis. Renal function improved and dialysis was discontinued after three treatments. The corticosteroid dosage was gradually tapered. Renal function after 72 months of follow-up has remained stable (serum creatinine, approximately 1.9 mg/dL) and except for one relapse, there has been no clinical or serologic evidence of lupus activity. Furthermore, 24-hour urinary protein excretion has remained within the normal range.
Singh
A K
AK
Division of Nephrology, New England Medical Center, Boston, MA 02111, USA.
Ucci
A
A
Madias
N E
NE
D058186:Acute Kidney Injury / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology; D007684:Kidney Tubules / Q000276:immunology / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000453:epidemiology / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use
D005938:Glucocorticoids; D011241:Prednisone