title: Granulomatous interstitial nephritis: a clinicopathologic study of 46 cases from a single institution.
abstract: Acute interstitial nephritis is commonly seen in kidney biopsies of patients with acute renal failure; however, granulomatous interstitial nephritis (GIN) is rare. We identified 46 cases of GIN in a 17-year period in this institution and we investigated their most probable etiologies. Complete clinical information was available in 38 patients. Seventeen of 38 patients (44.7%) were classified as drug-induced. Renal sarcoidosis was responsible for 28.9% of cases, and the remaining 15.9% of cases included Wegeners granulomatosis, foreign body giant cell reaction, GIN secondary to intravesical bacillus Calmette-Guérin therapy for bladder cancer, and xanthogranulomatous pyelonephritis. Clinical investigation failed to reveal possible etiology in 4 patients (10.5%), classified as idiopathic. We concluded that three quarters of our cases were either drug-induced or due to sarcoidosis; only a small proportion of our cases occurred secondary to any other cause or to unknown factors.
authors.affiliation: Department of Pathology, Brigham and Womens Hospital--Harvard Medical School, Boston, MA, USA.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Bijol
authors.forename: Gonzalo P
authors.initials: GP
authors.lastname: Mendez
authors.forename: Vânia
authors.initials: V
authors.lastname: Nosé
authors.forename: Helmut G
authors.initials: HG
authors.lastname: Rennke
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001500:BCG Vaccine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005549:Foreign-Body Reaction / Q000150:complications; D006099:Granuloma / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology*; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology*; D011705:Pyelonephritis, Xanthogranulomatous / Q000150:complications; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications; D001749:Urinary Bladder Neoplasms / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001500:BCG Vaccine