title: A possible rare cause of renal failure in streptococcal infection.
abstract: To the best of our knowledge, this is the first biopsy-proven case of streptococcal infection-associated acute interstitial nephritis (AIN) with existence of streptococcal pyrogenic exotoxin B (SPE B) by a controlled immunohistochemical method. Both the intact tubular epithelial cells and oedematous interstitium had strong positive signals, whereas only interstitial inflammation was dominant without tubular necrosis. Reflective of the nature of AIN is that the injury from the hypersensitivity reaction was specific for renal interstitium instead of tubules. SPE B is potentially allergenic and may confuse the clinicians due to its clinical mimicry of drug-induced AIN. Although very rare, AIN might be included into the differential diagnosis of patients with streptococcal sepsis and acute renal failure.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Chang
authors.forename: Yu-Sen
authors.initials: YS
authors.lastname: Peng
authors.forename: Chien-Chen
authors.initials: CC
authors.lastname: Tsai
authors.forename: Meng-Shiuan
authors.initials: MS
authors.lastname: Hsu
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
mesh_terms: D000208:Acute Disease; D000328:Adult; D001426:Bacterial Proteins / Q000378:metabolism; D005098:Exotoxins / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D009395:Nephritis, Interstitial / Q000209:etiology* / Q000473:pathology; D051437:Renal Insufficiency / Q000209:etiology* / Q000473:pathology; D013290:Streptococcal Infections / Q000150:complications* / Q000382:microbiology; D013291:Streptococcus / Q000472:pathogenicity*; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D005098:Exotoxins; C027951:erythrogenic toxin