BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various medications.While medication-induced interstitial nephritis is common,occurrences due to non-pharma...BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various medications.While medication-induced interstitial nephritis is common,occurrences due to non-pharmacological factors are rare.This report presents a case of severe AKI triggered by intratubular oxalate crystal deposition,leading to interstitial nephritis.The aim is to outline the case and its management,emphasizing the significance of recognizing uncommon causes of interstitial nephritis.CASE SUMMARY A 71-year-old female presented with stroke-like symptoms,including weakness,speech difficulties,and cognitive impairment.Chronic hypertension had been managed with hydrochlorothiazide(HCTZ)for over two decades.Upon admis-sion,severe hypokalemia and AKI were noted,prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial nephritis.Further investigations,including kidney biopsy,confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying cause.Despite treatment,initial renal function showed minimal improvement.However,with prednisolone therapy and supportive measures,her condition gradually improved,high-lighting the importance of comprehensive management.CONCLUSION This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial nephritis.The occurrence of interstitial nephritis due to oxalate crystal deposition,especially without typical risk factors,emphasizes the need for vigilance in clinical practice.展开更多
Calcineurin inhibitors (CNI) are potent immunosuppressive agents in prophylaxis against graft rejection and autoimmune diseases including primary glomerulopathies. Previous research showed reversible;acute afferent ar...Calcineurin inhibitors (CNI) are potent immunosuppressive agents in prophylaxis against graft rejection and autoimmune diseases including primary glomerulopathies. Previous research showed reversible;acute afferent arteriolar vasculopathy and irreversible chronic interstitial fibrosis associated with CNI nephrotoxicity. In this case report we describe a patient, with minimal change disease, that had developed chronic and progressive renal disease while receiving therapeutic dose of Tacrolimus. His serum creatinine had reached 537 umol/L and his nephrotic state worsened. Kidney biopsy showed chronic interstitial nephritis. Tacrolimus was discontinued and he was treated with 1 mg/kg prednisone in addition to Mycophenolate mofetil (MMF) 1 g twice daily. By the 2<sup>nd</sup> month;serum creatinine returned to normal and by the 3<sup>rd</sup> month serum albumin too. After 1 month of therapy;the dose of Prednisone was tapered down gradually till 5 mg daily by the end of 3<sup>rd</sup> month. Moreover, the dose of MMF was reduced to 500 mg X2 by the end of 3<sup>rd</sup> month. After 2 years of follow up;he remained stable and without relapse of NS or renal failure. In conclusion, reversible renal disease, due to chronic interstitial nephritis can be induced by CNI which is amenable to treatment with Prednisone and MMF.展开更多
Staphylococcus associated glomerulonephritis (SAGN) is an uncommon infection-related glomerulonephritis. Although infection is typically ongoing when patients present with SAGN, in the case of deep-seated infections, ...Staphylococcus associated glomerulonephritis (SAGN) is an uncommon infection-related glomerulonephritis. Although infection is typically ongoing when patients present with SAGN, in the case of deep-seated infections, the presence of infection may not be apparent. The aim of this study is to highlight the importance of renal biopsy when the diagnosis is not obvious. We present a case of staphylococcus associated glomerulonephritis in a patient treated with beta-lactam antibiotics for staphylococcus bacteraemia. A renal biopsy helped differentiate between interstitial nephritis and staphylococcus associated glomerulonephritis.展开更多
Objective:To explore the clinical and pathological features of Fabry disease complication of acute interstitial nephritis.Methods:A retrospective analysis of a patient with Fabry disease and acute interstitial nephrit...Objective:To explore the clinical and pathological features of Fabry disease complication of acute interstitial nephritis.Methods:A retrospective analysis of a patient with Fabry disease and acute interstitial nephritis diagnosed and in the Department of Nephrology,Children’s Hospital Affiliated to Capital Institute of Pediatrics in January 2017 was performed.A literature search was performed with“Fabry disease,acute interstitial nephritis”as the keywords in Wanfang database and PubMeds database.Result:The patient was 10-years-old with acute renal dysfunction.Electron microscopy showed stratified myelin-like bodies,zebra bodies and fused foot segment.The patient was finally diagnosed with the combination of Fabry disease and acute interstitial nephritis.By now,such cases have been reported.Conclusion:Whether Fabry's disease and acute interstitial nephritis shared the common pathogenic mechanism is unclear.Early renal biopsy is important for the diagnosis of this disease.展开更多
930568 The production and significance of IL4in patients with idiopathic nephroctic syndrome.YAO Zhi(姚智),et al.Dept Immunol,BeijingMed Univ,Beijing,100083,Natl Med J China1993;73(5):261—263.Samples of serum and PBM...930568 The production and significance of IL4in patients with idiopathic nephroctic syndrome.YAO Zhi(姚智),et al.Dept Immunol,BeijingMed Univ,Beijing,100083,Natl Med J China1993;73(5):261—263.Samples of serum and PBMC were collected atthe same time from 42 pediatric patients with id-iopathic nephrotic syndrome(INS)and 28 age—matched healthy individuals.The level os IgE inserum was detected and IL4 in supernatant ofPHA-activated PBMC assayed by sandwichELISA.The levels of IL4 and IgE in healthy in-dividuals were 400～500 pg/ml and 50～100 U/ml respectively,and those of IL and IgE in theINS patients were on the average 1080～4000Pg/ml and 380～1000 U/ml.Positive correla-展开更多
970370 The expression of AT1A receptor and itsmodulation by benazepril in the renal tubulointerstitiallesions induced by ureteral obstruction. CHEN Xi-angmei(陈香美), et al. Nephrol Div, General Hosp,PLA, Beijing, 100...970370 The expression of AT1A receptor and itsmodulation by benazepril in the renal tubulointerstitiallesions induced by ureteral obstruction. CHEN Xi-angmei(陈香美), et al. Nephrol Div, General Hosp,PLA, Beijing, 100853. Natl Med J China 1997; 77(4):245-248.展开更多
920149 The relationship between renal tis-sue subsets of lymphocytes and clinicalfeatures in IgA nephropathy.LIU Zhihong （刘志红）,et al.Dept Nephrol,Jinling Hosp,Nanjing（210002）.Chin J Nephrol 1991; 7 （4）: 230.A...920149 The relationship between renal tis-sue subsets of lymphocytes and clinicalfeatures in IgA nephropathy.LIU Zhihong （刘志红）,et al.Dept Nephrol,Jinling Hosp,Nanjing（210002）.Chin J Nephrol 1991; 7 （4）: 230.Amount of CD<sub>4</sub><sup>+</sup>,CD<sub>8</sub><sup>+</sup> and B cells in展开更多
920710 A study of the cytomegalovirus-DNA in serum and renal tissue of patients-with IgA nephropathy. LIU Zhihong(刘志红),et al. Dept Nephrol, Jinling Hosp,Nanjing,210002. Nail Med J China 1992; 72(4): 198-200. Cytome...920710 A study of the cytomegalovirus-DNA in serum and renal tissue of patients-with IgA nephropathy. LIU Zhihong(刘志红),et al. Dept Nephrol, Jinling Hosp,Nanjing,210002. Nail Med J China 1992; 72(4): 198-200. Cytomegalovirus (CMV) has been suspectedto be involved in the pathogenesis of IgA nep-展开更多
950358 Detection of glucocorticoid receptor (GCR)of lymphocyte in childnephrotic syndrome (NS).TANG Jieru(汤洁如),et al.Dept Pediatr,1st AffiliHosp,Sun Yat-sen Meal Univ,Guangzhou.Chin JNephrol 1994;10(6):342-343.Asse...950358 Detection of glucocorticoid receptor (GCR)of lymphocyte in childnephrotic syndrome (NS).TANG Jieru(汤洁如),et al.Dept Pediatr,1st AffiliHosp,Sun Yat-sen Meal Univ,Guangzhou.Chin JNephrol 1994;10(6):342-343.Assesment of steroid receptor content in humanneoplastic cells or mammary tumor cells has been pre-viously used to prearct steriod sensitivity in variouscancers.In the present study,we evaluated the rela-tionship between GCR content and the prednisone sen-展开更多
930331 Significance of determination of urinealbumin for early diagnosis of diabeticnephropathy.ZHOU Zhongyuan (周中源),Shanghai 4th People’s Hosp.Shanghai Med J1993;16(2):74—76.The results of urine albumin determin...930331 Significance of determination of urinealbumin for early diagnosis of diabeticnephropathy.ZHOU Zhongyuan (周中源),Shanghai 4th People’s Hosp.Shanghai Med J1993;16(2):74—76.The results of urine albumin determination in208 patients with non-insulin dependent dia-betes mellitus but tested negative for urinaryprotein on routine examination and in 177 nor-mal controls were reported.The results showedthat the excretion of urine albumin in 131 pa-tients was obviously higher than that in normalcontrols (p【0.001).In the diabetic patientstested negative for urinary protein on routineexamination the excretion of urine albumin展开更多
目的评价急性间质性肾炎(AIN)应用泼尼松治疗的临床效果。方法选择急性间质性肾炎患者80例,采用随机数字表法分为对照组和观察组,各40例。对照组行常规对症治疗,观察组在对照组基础上配合泼尼松治疗。对比两组患者临床疗效、生活质量评...目的评价急性间质性肾炎(AIN)应用泼尼松治疗的临床效果。方法选择急性间质性肾炎患者80例,采用随机数字表法分为对照组和观察组,各40例。对照组行常规对症治疗,观察组在对照组基础上配合泼尼松治疗。对比两组患者临床疗效、生活质量评分及治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(SCr)、尿β_(2)微球蛋白(β_(2)-MG)、24 h尿蛋白定量(24 h UP)、尿酸(UA)]。结果观察组总有效率95.00%高于对照组的80.00%(P<0.05)。观察组躯体功能、躯体角色、机体疼痛、总体健康、活力、社会功能、情绪角色、心理健康评分分别为(90.03±3.30)、(91.30±2.30)、(91.05±2.35)、(91.30±3.20)、(91.80±2.80)、(92.20±3.15)、(91.02±3.15)、(92.20±3.30)分,均明显高于对照组的(84.40±2.50)、(85.50±2.20)、(86.02±2.22)、(85.50±2.60)、(86.50±2.30)、(86.60±2.60)、(86.50±2.55)、(86.60±2.30)分(P<0.05)。治疗后,两组BUN、SCr、β_(2)-MG、24 h UP、UA水平均较治疗前下降,且观察组治疗后BUN(6.66±1.88)mmol/L、SCr(215.70±5.50)μmol/L、β_(2)-MG(0.25±0.10)mg/L、24 h UP(0.38±0.30)g/24 h、UA(339.40±9.01)μmol/L均低于对照组的(10.20±2.60)mmol/L、(410.50±8.80)μmol/L、(0.36±0.15)mg/L、(1.22±0.40)g/24 h、(444.02±9.50)μmol/L(P<0.05)。结论泼尼松治疗急性间质性肾炎的临床效果显著,可促进患者肾功能改善,且能提升患者的生活质量。展开更多
Objective: To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine. Methods: The medical histories concer...Objective: To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine. Methods: The medical histories concerned were collected with diagnostic images including CT scanning, ultrasonography, intravenous urography (IVU) and laboratory data being synthesized by comparison with what was discovered during operations and pathologic examinations. Results: All patients were ever struck on their loins or backs by blunt violence over 4-12 years. The diseases were clinically diagnosed as “renal cancer” before, during and after operations, and treated with radical nephrectomy. Located at cortical parts, the tumor focus had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were xanthogranulomas, not tumors, in which there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts yielded no bacterium, obstruction or calculus. Conclusions: XGIN is likely to be one kind of immunologic mediated granuloma following blunt renal trauma. It is imperative to clarify pathogenesis and character of this lesion so as to find out any approach to diagnosis and cure of such an unusual nephropathy.展开更多
文摘BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various medications.While medication-induced interstitial nephritis is common,occurrences due to non-pharmacological factors are rare.This report presents a case of severe AKI triggered by intratubular oxalate crystal deposition,leading to interstitial nephritis.The aim is to outline the case and its management,emphasizing the significance of recognizing uncommon causes of interstitial nephritis.CASE SUMMARY A 71-year-old female presented with stroke-like symptoms,including weakness,speech difficulties,and cognitive impairment.Chronic hypertension had been managed with hydrochlorothiazide(HCTZ)for over two decades.Upon admis-sion,severe hypokalemia and AKI were noted,prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial nephritis.Further investigations,including kidney biopsy,confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying cause.Despite treatment,initial renal function showed minimal improvement.However,with prednisolone therapy and supportive measures,her condition gradually improved,high-lighting the importance of comprehensive management.CONCLUSION This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial nephritis.The occurrence of interstitial nephritis due to oxalate crystal deposition,especially without typical risk factors,emphasizes the need for vigilance in clinical practice.
文摘Calcineurin inhibitors (CNI) are potent immunosuppressive agents in prophylaxis against graft rejection and autoimmune diseases including primary glomerulopathies. Previous research showed reversible;acute afferent arteriolar vasculopathy and irreversible chronic interstitial fibrosis associated with CNI nephrotoxicity. In this case report we describe a patient, with minimal change disease, that had developed chronic and progressive renal disease while receiving therapeutic dose of Tacrolimus. His serum creatinine had reached 537 umol/L and his nephrotic state worsened. Kidney biopsy showed chronic interstitial nephritis. Tacrolimus was discontinued and he was treated with 1 mg/kg prednisone in addition to Mycophenolate mofetil (MMF) 1 g twice daily. By the 2<sup>nd</sup> month;serum creatinine returned to normal and by the 3<sup>rd</sup> month serum albumin too. After 1 month of therapy;the dose of Prednisone was tapered down gradually till 5 mg daily by the end of 3<sup>rd</sup> month. Moreover, the dose of MMF was reduced to 500 mg X2 by the end of 3<sup>rd</sup> month. After 2 years of follow up;he remained stable and without relapse of NS or renal failure. In conclusion, reversible renal disease, due to chronic interstitial nephritis can be induced by CNI which is amenable to treatment with Prednisone and MMF.
文摘Staphylococcus associated glomerulonephritis (SAGN) is an uncommon infection-related glomerulonephritis. Although infection is typically ongoing when patients present with SAGN, in the case of deep-seated infections, the presence of infection may not be apparent. The aim of this study is to highlight the importance of renal biopsy when the diagnosis is not obvious. We present a case of staphylococcus associated glomerulonephritis in a patient treated with beta-lactam antibiotics for staphylococcus bacteraemia. A renal biopsy helped differentiate between interstitial nephritis and staphylococcus associated glomerulonephritis.
文摘Objective:To explore the clinical and pathological features of Fabry disease complication of acute interstitial nephritis.Methods:A retrospective analysis of a patient with Fabry disease and acute interstitial nephritis diagnosed and in the Department of Nephrology,Children’s Hospital Affiliated to Capital Institute of Pediatrics in January 2017 was performed.A literature search was performed with“Fabry disease,acute interstitial nephritis”as the keywords in Wanfang database and PubMeds database.Result:The patient was 10-years-old with acute renal dysfunction.Electron microscopy showed stratified myelin-like bodies,zebra bodies and fused foot segment.The patient was finally diagnosed with the combination of Fabry disease and acute interstitial nephritis.By now,such cases have been reported.Conclusion:Whether Fabry's disease and acute interstitial nephritis shared the common pathogenic mechanism is unclear.Early renal biopsy is important for the diagnosis of this disease.
文摘930568 The production and significance of IL4in patients with idiopathic nephroctic syndrome.YAO Zhi(姚智),et al.Dept Immunol,BeijingMed Univ,Beijing,100083,Natl Med J China1993;73(5):261—263.Samples of serum and PBMC were collected atthe same time from 42 pediatric patients with id-iopathic nephrotic syndrome(INS)and 28 age—matched healthy individuals.The level os IgE inserum was detected and IL4 in supernatant ofPHA-activated PBMC assayed by sandwichELISA.The levels of IL4 and IgE in healthy in-dividuals were 400～500 pg/ml and 50～100 U/ml respectively,and those of IL and IgE in theINS patients were on the average 1080～4000Pg/ml and 380～1000 U/ml.Positive correla-
文摘970370 The expression of AT1A receptor and itsmodulation by benazepril in the renal tubulointerstitiallesions induced by ureteral obstruction. CHEN Xi-angmei(陈香美), et al. Nephrol Div, General Hosp,PLA, Beijing, 100853. Natl Med J China 1997; 77(4):245-248.
文摘920149 The relationship between renal tis-sue subsets of lymphocytes and clinicalfeatures in IgA nephropathy.LIU Zhihong （刘志红）,et al.Dept Nephrol,Jinling Hosp,Nanjing（210002）.Chin J Nephrol 1991; 7 （4）: 230.Amount of CD<sub>4</sub><sup>+</sup>,CD<sub>8</sub><sup>+</sup> and B cells in
文摘920710 A study of the cytomegalovirus-DNA in serum and renal tissue of patients-with IgA nephropathy. LIU Zhihong(刘志红),et al. Dept Nephrol, Jinling Hosp,Nanjing,210002. Nail Med J China 1992; 72(4): 198-200. Cytomegalovirus (CMV) has been suspectedto be involved in the pathogenesis of IgA nep-
文摘950358 Detection of glucocorticoid receptor (GCR)of lymphocyte in childnephrotic syndrome (NS).TANG Jieru(汤洁如),et al.Dept Pediatr,1st AffiliHosp,Sun Yat-sen Meal Univ,Guangzhou.Chin JNephrol 1994;10(6):342-343.Assesment of steroid receptor content in humanneoplastic cells or mammary tumor cells has been pre-viously used to prearct steriod sensitivity in variouscancers.In the present study,we evaluated the rela-tionship between GCR content and the prednisone sen-
文摘930331 Significance of determination of urinealbumin for early diagnosis of diabeticnephropathy.ZHOU Zhongyuan (周中源),Shanghai 4th People’s Hosp.Shanghai Med J1993;16(2):74—76.The results of urine albumin determination in208 patients with non-insulin dependent dia-betes mellitus but tested negative for urinaryprotein on routine examination and in 177 nor-mal controls were reported.The results showedthat the excretion of urine albumin in 131 pa-tients was obviously higher than that in normalcontrols (p【0.001).In the diabetic patientstested negative for urinary protein on routineexamination the excretion of urine albumin
文摘目的评价急性间质性肾炎(AIN)应用泼尼松治疗的临床效果。方法选择急性间质性肾炎患者80例,采用随机数字表法分为对照组和观察组,各40例。对照组行常规对症治疗,观察组在对照组基础上配合泼尼松治疗。对比两组患者临床疗效、生活质量评分及治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(SCr)、尿β_(2)微球蛋白(β_(2)-MG)、24 h尿蛋白定量(24 h UP)、尿酸(UA)]。结果观察组总有效率95.00%高于对照组的80.00%(P<0.05)。观察组躯体功能、躯体角色、机体疼痛、总体健康、活力、社会功能、情绪角色、心理健康评分分别为(90.03±3.30)、(91.30±2.30)、(91.05±2.35)、(91.30±3.20)、(91.80±2.80)、(92.20±3.15)、(91.02±3.15)、(92.20±3.30)分,均明显高于对照组的(84.40±2.50)、(85.50±2.20)、(86.02±2.22)、(85.50±2.60)、(86.50±2.30)、(86.60±2.60)、(86.50±2.55)、(86.60±2.30)分(P<0.05)。治疗后,两组BUN、SCr、β_(2)-MG、24 h UP、UA水平均较治疗前下降,且观察组治疗后BUN(6.66±1.88)mmol/L、SCr(215.70±5.50)μmol/L、β_(2)-MG(0.25±0.10)mg/L、24 h UP(0.38±0.30)g/24 h、UA(339.40±9.01)μmol/L均低于对照组的(10.20±2.60)mmol/L、(410.50±8.80)μmol/L、(0.36±0.15)mg/L、(1.22±0.40)g/24 h、(444.02±9.50)μmol/L(P<0.05)。结论泼尼松治疗急性间质性肾炎的临床效果显著,可促进患者肾功能改善,且能提升患者的生活质量。
文摘Objective: To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine. Methods: The medical histories concerned were collected with diagnostic images including CT scanning, ultrasonography, intravenous urography (IVU) and laboratory data being synthesized by comparison with what was discovered during operations and pathologic examinations. Results: All patients were ever struck on their loins or backs by blunt violence over 4-12 years. The diseases were clinically diagnosed as “renal cancer” before, during and after operations, and treated with radical nephrectomy. Located at cortical parts, the tumor focus had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were xanthogranulomas, not tumors, in which there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts yielded no bacterium, obstruction or calculus. Conclusions: XGIN is likely to be one kind of immunologic mediated granuloma following blunt renal trauma. It is imperative to clarify pathogenesis and character of this lesion so as to find out any approach to diagnosis and cure of such an unusual nephropathy.
