Kamińska Anna, Roszkowska-Blaim Maria, Weglarska Jolanta, Szymanik-Grzelak Hanna, Sołtyski Jarosław, Wasiutyński Aleksander, Fiejka Elzbieta
Z Katedry i Kliniki Pediatrii i Nefrologii, Akademii Medycznej w Warszawie.
Wiad Lek. 2005;58 Suppl 1:93-7.
Interstitial nephritis (IN) can occur as a result of different injury factors, among them: infections, drugs, toxins. The aim of the study was the presentation of rare causes of IN in 2 patients who were hospitalized in the Department of Pediatrics and Nephrology of Medical University of Warsaw. Case 1. A 15-years-old girl, with biopsy proven IN, who presented with a slight impairment of kidney function (creatinine level 1.1 mg/dl) and symptoms of tubulopathy at the beginning of the illness. Hypergammaglobulinemia, anemia, increase of CRP level and high ESR were noticed. Among others causes CMV infection was suspected. After CMV detection seroconversion in titres of anti- CMV IgM and IgG antibodies was observed. Kidney biopsy revealed IN and positive reaction to CMV antigen in tubular epithelial cells. Case 2. A 12,5-years-old boy with acute renal failure (ARF) (creatinine and urea concentration respectively: 11.3 mg/dl, 131.4 mg/dl) was admitted to the hospital. In kidney biopsy acute IN with tubulopathy and intense involvement of renal tissue was found. In further investigation inhaled stimulating factor was suspected as the possible cause of renal changes development - IN and ARF.
Considering the etiology of IN in children, CMV infection, the application of drugs and other chemical substances should be mentioned among the rare causes of the illness.
间质性肾炎(IN)可由不同的损伤因素引起,其中包括:感染、药物、毒素。本研究的目的是介绍在华沙医科大学儿科和肾病科住院的2例IN的罕见病因。病例1。一名15岁女孩,经活检证实为IN,患病初期出现轻微肾功能损害(肌酐水平1.1mg/dl)和肾小管病症状。发现有高丙种球蛋白血症、贫血、C反应蛋白水平升高和血沉加快。怀疑其他病因中包括巨细胞病毒(CMV)感染。检测到CMV后,观察到抗CMV IgM和IgG抗体滴度的血清学转换。肾活检显示为IN,肾小管上皮细胞对CMV抗原呈阳性反应。病例2。一名12.5岁男孩因急性肾衰竭(ARF)(肌酐和尿素浓度分别为:11.3mg/dl,131.4mg/dl)入院。肾活检发现急性IN伴肾小管病,肾组织受累严重。进一步检查怀疑吸入性刺激因子是肾脏病变发展(IN和ARF)的可能原因。
考虑儿童IN的病因,CMV感染、药物及其他化学物质的应用应列为该病的罕见病因。