title: [Yersiniosis as a cause of acute tubulointerstitial nephritis and acute renal failure--case report].
abstract: Tubulointerstitial nephritis (TN) is a heterogenous disease, where disturbances of the interstitial tissue and renal tubules are found. Different immunological and nonimmunological mechanisms initiated by infectious and non-infectious factors may lead to TN. A case of 13-years-old girl with primary diagnosis of acute pyelonephritis is presented. The abdominal pain, headache, pain in lumbar region and intermittent fever with loss of appetite were observed in this girl a few weeks before admission. Microcytic anemia, proteinuria and glucosuria, azotemia and elevated markers of inflammatory response were found. In ultrasound examination heterogenous cortex echogenicity of both kidneys and disturbances in parenchymal blood flow were observed. In renal scintigraphy the discriminated catch index was found. Kidney biopsy revealed the edema of the interstitial space with mononuclear and lymphocyte infiltration. The diagnosis of TN was established upon the history, clinical examination, results of laboratory tests, kidney imaging and biopsy. After steroid and doxycycline treatment an improvement and normalization of the results of laboratory tests were observed. It seems to be justified to consider Yersinia infection as a cause of acute tubulointerstitial nephritis.
authors.affiliation: Z Kliniki Kardiologii i Nefrologii Dzieciecej I Katedry Pediatrii, Dzieciecej Akademii Medycznej w Poznaniu.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Runowski
authors.forename: Norbert
authors.initials: N
authors.lastname: Szymoniak
authors.forename: Marcin
authors.initials: M
authors.lastname: Zaniew
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Piatkowska-Kopczyk
authors.forename: Aldona
authors.initials: A
authors.lastname: Wozniak
authors.forename: Paweł
authors.initials: P
authors.lastname: Kroll
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000382:microbiology*; D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D009395:Nephritis, Interstitial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology*; D011866:Radioisotope Renography; D014463:Ultrasonography; D015009:Yersinia Infections / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging