title: IgG4-related tubulointerstitial nephritis presenting with psychiatric manifestations and skin lesions.
abstract: We describe a 21-year male with mood disorder on lithium therapy and psoriasis-like skin lesions presenting with rapidly progressive renal failure. The kidney biopsy showed acute tubulointerstitial nephritis with immunoglobulin G4-positive plasma cell infiltration. He was started on oral steroids with a provisional diagnosis of IgG4-related tubulointerstitial nephritis. All dermatological, psychiatric and renal manifestations dramatically improved, and he was taken off lithium. He had a relapse of his psychiatric symptoms on stopping steroids, and they again responded to steroids.
authors.affiliation: Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Rajakumar
authors.forename: Amit
authors.initials: A
authors.lastname: Rawat
authors.forename: Ritambhra
authors.initials: R
authors.lastname: Nada
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumar
authors.forename: Manish
authors.initials: M
authors.lastname: Rathi
authors.forename: Harbir S
authors.initials: HS
authors.lastname: Kohli
authors.forename: Vinay
authors.initials: V
authors.lastname: Sakhuja
authors.forename: Vivekanand
authors.initials: V
authors.lastname: Jha
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000097:blood; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D019964:Mood Disorders / Q000150:complications* / Q000188:drug therapy; D009395:Nephritis, Interstitial / Q000150:complications* / Q000188:drug therapy; D010950:Plasma Cells / Q000737:chemistry; D011239:Prednisolone / Q000627:therapeutic use; D012871:Skin Diseases / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014150:Antipsychotic Agents; D007074:Immunoglobulin G; D008094:Lithium; D011239:Prednisolone