Interstitial nephritis: Difference between revisions

Latest revision as of 20:01, 2 August 2020

Etiology

Drugs

Nonsteroidal antiinflammatory agents (NSAIDs)
- Includes selective cyclooxygenase (COX)-2 inhibitors and mesalamine
Antimicrobials
Diuretics, including furosemide and thiazides
Cimetidine
Allopurinol
Proton pump inhibitors (PPIs)

Infections

Long list, including Legionella, Leptospira, cytomegalovirus, streptococci, Mycobacterium tuberculosis, Corynebacterium diphtheriae, Epstein-Barr virus, Yersinia, polyomavirus, Enterococcus, Escherichia coli, adenovirus, and Candida

Autoimmune Disorders

Clinical Manifestations

Can be asymptomatic, presenting with renal dysfunction
Nausea, vomiting, malaise, and oliguria
May have arthralgias
With drug-induced AIN, can have an allergic syndrome that includes fever, eosinophilia, and rash

Investigations

Creatinine, showing AKI
CBC, showing eosinophilia
Urine studies
- May have pyuria and white cell casts and RBCs, and eosinophiluria
- Usually around 1 g/day of proteinuria
- FENa >1%

@@ Line 1: / Line 1: @@
-== Etiology ==
+==Etiology==
-=== Drugs ===
+===Drugs===
-* Nonsteroidal antiinflammatory agents (NSAIDs)
+*Nonsteroidal antiinflammatory agents (NSAIDs)
-** Includes selective cyclooxygenase (COX)-2 inhibitors and mesalamine
+**Includes selective cyclooxygenase (COX)-2 inhibitors and [[mesalamine]]
-* Antimicrobials
+*Antimicrobials
-** Penicillins and cephalosporins
+**[[Penicillin|Penicillins]] and [[Cephalosporin|cephalosporins]]
-** Rifampin
+**[[Rifampin]]
-** Trimethoprim-sulfamethoxazole
+**[[Trimethoprim-sulfamethoxazole]]
-** Ciprofloxacin
+**[[Ciprofloxacin]]
-** Indinavir
+**[[Indinavir]]
-* Diuretics, including furosemide and thiazides
+*Diuretics, including [[furosemide]] and [[Thiazide|thiazides]]
-* Cimetidine
+*[[Cimetidine]]
-* Allopurinol
+*[[Allopurinol]]
-* Proton pump inhibitors (PPIs)
+*[[Proton pump inhibitor|Proton pump inhibitors]] (PPIs)
-=== Infections ===
+===Infections===
-Long list, including ''Legionella'', ''Leptospira'', cytomegalovirus (CMV), ''Streptococcus'', ''Mycobacterium tuberculosis'', ''Corynebacterium diphtheriae'', Epstein-Barr virus (EBV), ''Yersinia'', polyomavirus, ''Enterococcus'', ''Escherichia coli'', adenovirus, and ''Candida''.
+* Long list, including ''[[Legionella]]'', ''[[Leptospira]]'', [[cytomegalovirus]], [[streptococci]], ''[[Mycobacterium tuberculosis]]'', ''[[Corynebacterium diphtheriae]]'', [[Epstein-Barr virus]], ''[[Yersinia]]'', [[polyomavirus]], ''[[Enterococcus]]'', ''[[Escherichia coli]]'', [[adenovirus]], and ''[[Candida]]''
-=== Autoimmune Disorders ===
+===Autoimmune Disorders===
-* Systemic lupus erythematosus
+*[[Systemic lupus erythematosus]]
-* Sarcoidosis
+*[[Sarcoidosis]]
-* Sjögren syndrome
+*[[Sjögren syndrome]]
-* IgG4 disease
+*[[IgG4 disease]]
-== Clinical Manifestations ==
+==Clinical Manifestations==
-* Can be asymptomatic, presenting with renal dysfunction
+*Can be asymptomatic, presenting with renal dysfunction
-* Nausea, vomiting, malaise, and oliguria
+*Nausea, vomiting, malaise, and oliguria
-* May have arthralgias
+*May have arthralgias
-* With drug-induced AIN, can have an allergic syndrome that includes fever, eosinophilia, and rash
+*With drug-induced AIN, can have an allergic syndrome that includes fever, eosinophilia, and rash
-== Investigations ==
+==Investigations==
-* Creatinine, showing AKI
+*Creatinine, showing AKI
-* CBC, showing eosinophilia
+*CBC, showing eosinophilia
-* Urine studies
+*Urine studies
-** May have pyuria and white cell casts and RBCs, and eosinophiluria
+**May have pyuria and white cell casts and RBCs, and eosinophiluria
-** Usually around 1 g/day of proteinuria
+**Usually around 1 g/day of proteinuria
-** FENa &gt;1%
+**FENa &gt;1%
 [[Category:Nephrology]]