Clinicopathological Findings in Pediatric Tubulointerstitial Nephritis: Iranian Experience
Journal of Pediatric Nephrology,
Vol. 3 No. 4 (2015),
,
Page 139-142
https://doi.org/10.22037/jpn.v3i4.8844
Abstract
Introduction: Tubulointerstitial disorders are characterized by diseases that affect the vascular and interstitial compartments of the kidney with relative sparing of the glomeruli. They might be either acute or chronic. Acute tubulointerstitial nephritis (TIN) is associated with acute renal failure due to either acute infection of the kidneys or reaction to medication. Chronicinterstitial nephritis is characterized by many syndromes of renal tubular dysfunction that may be primary or secondary due to renal tubular damage from a wide variety of causes. The aim of this study was to evaluate the pathologic characteristics of acute and chronic TIN and their probable causes.
Materials and Methods: All native kidney biopsy specimens with a diagnosis of tubulointerstitial nephritis admitted to Ali-Asghar Hospital, a pediatric referral center in Tehran, from 1983 to 2013 were retrospectively re-evaluated. The demographic data of the patients were collected and pathologic findings were reviewed.
Results: Forty-four patients, 18 males and 26 females with a mean age of 8.8 years (SD=4), were enrolled in this study. Thirty-seven (84%) patients had chronic and 7 (16%) had acute TIN. The disease was primary in 32 (72%) patients with a diagnosis of familial nephronophthisis and medullary cystic disease and 12 (28%) had other diseases. Kidney biopsy showed similar pathologic findings including periglomerular fibrosis (72%), different scores of interstitial fibrosis/tubular atrophy (91%), infiltration of inflammatory cells, and segmental and global glomerular sclerosis (89%).
Conclusions: Acute and chronic tubulointerstitial nephritis with different etiologies has similar pathologic findings. The patients mostly present in the late stages of the disease; therefore, determining the etiology is impossible. Many cases are congenital.
Keywords: Nephritis, Interstitial, Child, Renal Insufficiency.How to Cite
References
Li Z, Kang Z, Duan C, Wu T, Zhang L, Xun M, et al.Clinical and pathological features of acute kidney injury in children.Ren Fail. 2014 Aug;36(7):1023-8.
Nikolić V, Bogdanović R, Ognjanović M, StajićN.Acutetubulointerstitial nephritis in children].SrpArhCelokLek. 2001 May-Jun;129.
Hawkins EP1,Berry PL, Silva FG.Acutetubulointerstitial nephritis in children: clinical, morphologic, and lectin studies. A report of the Southwest Pediatric Nephrology Study Group.Am J Kidney Dis. 1989 Dec;14(6):466-71.
Goicoechea M, Rivera F, López-Gómez JM; Spanish Registry of Glomerulonephritis.Increased prevalence of acute tubulointerstitialnephritis.Nephrol Dial Transplant. 2013 Jan;28(1):112-5.
Muriithi AK, Leung N, Valeri AM, Cornell LD, Sethi S, Fidler ME, et al.Biopsy-proven acute interstitial nephritis, 1993-2011: a case series.Am J Kidney Dis. 2014 Oct;64(4):558-66.
Raza MN, Hadid M, Keen CE, Bingham C, Salmon AH.Acutetubulointerstitial nephritis, treatment with steroid and impact on renal outcomes.Nephrology (Carlton). 2012 Nov;17(8):748-53.
Amira-Peco-Antić, ParipovićD.Acute kidney injury in childrenSrpArhCelokLek. 2014 May-Jun;142(5-6).
Pusey CD, Saltissi D, Bloodworth L, Rainford DJ, Christie JL.Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy.Q J Med. 1983 Spring;52(206):194-211.
Sampathkumar K, Ramalingam R, Prabakar A, Abraham A.Acute interstitial nephritis due to proton pump inhibitors.Indian J Nephrol. 2013 Jul;23(4):304-7.
Baker RJ, Pusey CD.The changing profile of acute tubulointerstitial nephritis. Nephrol Dial Transplant. 2004 Jan;19(1):8-11.
Schubert C, Bates WD, Moosa MR. Acutetubulointerstitial nephritis related to antituberculous drug therapy.ClinNephrol. 2010 Jun;73(6):413-9
Gregorini G, Izzi C, Ravani P, Obici L, Dallera N, Del Barba A, Negrinelli A, et al..Tubulointerstitial nephritis is a dominant feature of hereditary apolipoprotein A-I amyloidosis.Kidney Int. 2015 Jan 7.Kidney
Schubert C, Bates WD, Moosa MR. Acute tubulointerstitial nephritis related to antituberculous drug therapy. ClinNephrol. 2010 Jun;73(6):413-9.
Kidder D, Stewart GA, Furrie E, Fleming S. The case. Idiopathic hypocomplementemic interstitial nephritis. Diagnosis: Idiopathic hypocomplementemictubulointerstitial nephritis Kidney Int. 2015 Feb;87(2):485-6.
Krishnan N, Perazella MA. Drug-induced acute interstitial nephritis: pathology, pathogenesis, and treatment. Iran J Kidney Dis. 2015 Jan;9(1):3-13.
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