Interstitial nephritis: Difference between revisions
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| − | == |
+ | ==Etiology== |
| − | === |
+ | ===Drugs=== |
| − | * |
+ | *Nonsteroidal antiinflammatory agents (NSAIDs) |
| − | ** |
+ | **Includes selective cyclooxygenase (COX)-2 inhibitors and [[mesalamine]] |
| − | * |
+ | *Antimicrobials |
| − | ** |
+ | **[[Penicillin|Penicillins]] and [[Cephalosporin|cephalosporins]] |
| − | ** |
+ | **[[Rifampin]] |
| − | ** |
+ | **[[Trimethoprim-sulfamethoxazole]] |
| − | ** |
+ | **[[Ciprofloxacin]] |
| − | ** |
+ | **[[Indinavir]] |
| − | * |
+ | *Diuretics, including [[furosemide]] and [[Thiazide|thiazides]] |
| − | * |
+ | *[[Cimetidine]] |
| − | * |
+ | *[[Allopurinol]] |
| − | * Proton pump inhibitors (PPIs) |
+ | *[[Proton pump inhibitor|Proton pump inhibitors]] (PPIs) |
| − | === |
+ | ===Infections=== |
| − | Long list, including ''Legionella'', ''Leptospira'', cytomegalovirus |
+ | * Long list, including ''[[Legionella]]'', ''[[Leptospira]]'', [[cytomegalovirus]], [[streptococci]], ''[[Mycobacterium tuberculosis]]'', ''[[Corynebacterium diphtheriae]]'', [[Epstein-Barr virus]], ''[[Yersinia]]'', [[polyomavirus]], ''[[Enterococcus]]'', ''[[Escherichia coli]]'', [[adenovirus]], and ''[[Candida]]'' |
| − | === |
+ | ===Autoimmune Disorders=== |
| − | * |
+ | *[[Systemic lupus erythematosus]] |
| − | * |
+ | *[[Sarcoidosis]] |
| − | * |
+ | *[[Sjögren syndrome]] |
| − | * |
+ | *[[IgG4 disease]] |
| − | == |
+ | ==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% |
[[Category:Nephrology]] |
[[Category:Nephrology]] |
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Latest revision as of 16:01, 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%
