title: [Acute tubulointerstitial nephritis following adenovirus and respiratory syncytial virus infection].
abstract: Acute tubulointerstitial nephritis (TIN) is responsible for nearly 10% of acute renal failure (ARF) cases in children. It is mostly drug-induced, but in a few cases viruses are involved, probably by an indirect mechanism. An immune-competent 13-month-old boy was admitted to the intensive care unit for severe ARF with anuria in a context of fever, cough, and rhinorrhea lasting 1 week. The kidney biopsy performed early brought out tubulointerstitial damage with mild infiltrate of lymphocytes, without any signs of necrosis. There were no virus inclusion bodies, no interstitial hemorrhage, and no glomerular or vascular damage. Other causes of TIN were excluded: there was no biological argument for an immunological, immune, or drug-induced cause. Adenovirus (ADV) and respiratory syncytial virus (RSV) were positive in respiratory multiplex polymerase chain reaction (PCR) in nasal aspirate but not in blood, urine, and renal tissue. The patient underwent dialysis for 10 days but the response to corticosteroid therapy was quickly observed within 48 h. The mechanism of TIN associated with virus infection is unknown. However, it may be immune-mediated to be able to link severe renal dysfunction and ADV and/or RSV invasion of the respiratory tract.
authors.affiliation: Clinique universitaire de réanimation pédiatrique et médecine néonatale, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France. Electronic address: aurelie.de-suremain@ch-metropole-savoie.fr.
authors.forename: A
authors.initials: A
authors.lastname: de Suremain
authors.affiliation: Clinique universitaire de réanimation pédiatrique et médecine néonatale, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France; Clinique universitaire de néphrologie pédiatrique, CHU de Grenoble, 38043 Grenoble cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Somrani
authors.affiliation: Clinique universitaire de néphrologie pédiatrique, CHU de Grenoble, 38043 Grenoble cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Bourdat-Michel
authors.affiliation: Institut de biologie et pathologie, départements de virologie et d'anatomie et cytologie pathologiques, CHU de Grenoble, 38043 Grenoble cedex 9, France.
authors.forename: N
authors.initials: N
authors.lastname: Pinel
authors.affiliation: Institut de biologie et pathologie, départements de virologie et d'anatomie et cytologie pathologiques, CHU de Grenoble, 38043 Grenoble cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Morel-Baccard
authors.affiliation: Clinique universitaire de réanimation pédiatrique et médecine néonatale, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: V
authors.initials: V
authors.lastname: Payen
mesh_terms: D000258:Adenovirus Infections, Human / Q000175:diagnosis* / Q000473:pathology; D000260:Adenoviruses, Human / Q000235:genetics / Q000302:isolation & purification; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D009395:Nephritis, Interstitial / Q000175:diagnosis* / Q000473:pathology; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000473:pathology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000305:Adrenal Cortex Hormones