Relapsing tubulointerstitial nephritis in an adolescent with inflammatory bowel disease without aminosalicylate exposure.
A 14-year-old boy presented with ongoing constipation as a manifestation of newly diagnosed Crohn's disease (CD) and a concomitant decline in renal function with biopsy-proven interstitial nephritis. Initiation of steroid therapy and mesalazine was associated with an improvement in symptoms and renal function. We describe a rare case of a 5-aminosalicylic acid (5-ASA)-naïve patient who developed interstitial nephritis in association with CD with no evidence of other primary glomerulopathy. A unique feature of the case being a profound systemic inflammatory response at the time of diagnosis and a relapse in nephritis 2 months after cessation of mesalazine in the absence of any macroscopic colitis.
Shahrani Muhammad
H S
HS
Department of Medicine, Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland. nurulislahtaib@hotmail.com
Peters
C
C
Casserly
L F
LF
Dorman
A M
AM
Watts
M
M
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D001706:Biopsy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D019804:Mesalamine / Q000009:adverse effects / Q000627:therapeutic use*; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine