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| Allergic Interstitial Nephritis | ||
| Etiology •Hypersensitivity type IV reaction. •Hypersensitivity reaction to penicillin, rifampin, nonsterioidal anti-inflammatory drugs, and sulfonamides account for most of the cases. •Many other drugs are capable of inducing interstitial nephritis (the list is long). | ||
| Pathogenesis •Cell mediated immune reaction., | ||
| Epidemiology •See etiology. | ||
| General Gross Description •The kidneys are bilaterally enlarged, pale and somewhat soft compared to normal. •On cut section the corticomedullary junction may be indistinct. •Examples: | ||
| General Microscopic Description •The interstitium is widened by a diffuse inflammatory infiltrate consisting predominantly of lymphocytes. •Plasma cells, scattered eosinophils and some neutrophils are also usually present. •The interstitium shows edema. •The tubules are of normal caliber and not atrophic. •The glomeruli and arterial vasculature appear normal. •Examples: | ||
| Clinical Correlation •The patients present with acute renal failure. •Urine sediment shows white cells, white cell casts, and occasionally eosinophils. •Mild proteinuria is present but not of nephrotic range. •Systemic manifestations of a hypersensitivity reaction such as rash, fever and arthralgias may be present. | ||
| References R • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 972-973. •Primer on Kidney Disease, Greenberg A (editor), 1994, National Kidney Foundation, pp.153-157. Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Allergic Interstitial Nephritis
| Synopsis by: Harold Yamase M.D. (T71060M00033)[223]
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