acute interstitial nephritis

(redirected from acute allergic nephritis)

a·cute in·ter·sti·tial ne·phri·tis

interstitial nephritis with variable tubular damage and infiltration by numerous neutrophils, resulting from bacterial infection, urinary tract obstruction, or other causes (including drugs), which may be hypersensitivity reactions; accompanied by renal failure, fever, blood or tissue eosinophilia, and rash.

acute interstitial nephritis

acute interstitial nephritis

Renal inflammation characterised by cellular—primarily mononuclear—and fluid exudates, often with epithelial degeneration.
 
Drug aetiology, acute interstitial nephritis
Antibiotics
• Beta lactams—penicillin, methicillin, ampicillin, amoxicillin, cephalosporines.
• Others—sulfonamides, rifampin, vancomycin, ethambutol, trimethoprim-sulfamathoxazole.

NSAIDs
Indomethacin, ibuprofen, naproxen, mefanamic acid, tolmetin, aspirin, phenylbutazone.

Diuretics
Furosemide, thiazides.

Others
Azathioprine, aldomet, carbamazepine, diphenylhidantoin, phenobarbital.

Findings-hypersensitivity
Fever, rash, sore throat, malaise, arthralgia, myalgia, hepatitis, splenomegaly, eosinophilia, lymphoadenopathy, thrombocytopaenia, autoimmune haemolysis.
 
Findings-anaphylaxis
Respiratory tract (laryngeal oedema, asthma); skin (urticaria, angioedema); GI tract (nausea and vomiting, diarrhea); cardiovascular (capillary leak, hypotension).
 
Types
Idiopathic, secondary to drugs (penicillins, ampicillin, sulpha drugs, NSAIDs, furosemide, thiazide diuretics) or infections.
 
Lab-Proximal tubule
Glycosuria, aminoaciduria, tubular proteinuria (usually < 1 g/24 h), hypouricaemia.
 
Lab-Distal tubule
Distal renal tubular acidosis, increased K+, isosthenuria, Na+ wasting.
 
Management
Corticosteroids may be effective.

Prognosis
Ranges from mild renal dysfunction to acute renal failure.

acute interstitial nephritis

Acute allergic nephritis Nephrology Renal inflammation characterized by cellular—primarily mononuclear—and fluid exudates, often with epithelial degeneration Types Idiopathic, 2º to drugs or infections Findings-hypersensitivity Fever, rash, sore throat, malaise, arthralgia, myalgia, hepatitis, splenomegaly, eosinophilia, lymphoadenopathy, thrombocytopenia, autoimmune hemolysis Findings-anaphylaxis Respiratory tract–laryngeal edema, asthma; skin–urticaria, angioedema; GI tract–N&V, diarrhea; cardiovascular–capillary leak, hypotension Lab-Proximal tubule Glycosuria, aminoaciduria, tubular proteinuria–usually < 1 g/24 h, hypouricemia Distal tubule Distal renal tubular acidosis, ↑ K+, isosthenuria, Na+ wasting Management Corticosteroids may be effective Prognosis From mild renal dysfunction to acute renal failure
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