Ogura Makoto, Kagami Shino, Nakao Masatsugu, Kono Midori, Kanetsuna Yukiko, Hosoya Tatsuo
Division of Kidney and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan.
Clin Kidney J. 2012 Oct;5(5):459-462. doi: 10.1093/ckj/sfs103.
We describe two cases of fungal granulomatous interstitial nephritis (GIN) presenting as acute kidney injury (AKI). Increased serum creatinine was detected in Patient 1 after chemotherapy for pharyngeal cancer and in Patient 2 after steroid pulse therapy for bronchial asthma. Renal histology of both patients revealed GIN. Polymerase chain reaction (PCR)-based detection of fungal DNA sequences from kidney tissue demonstrated and , respectively. When AKI occurs in an immunocompromised host, differential diagnosis of fungal interstitial nephritis should be considered. Furthermore, PCR-based detection of fungal DNA sequences from renal specimens can be useful for rapid diagnosis.
我们描述了两例表现为急性肾损伤(AKI)的真菌性肉芽肿性间质性肾炎(GIN)病例。病例1在接受鼻咽癌化疗后血清肌酐升高,病例2在接受支气管哮喘激素冲击治疗后血清肌酐升高。两名患者的肾脏组织学检查均显示为GIN。基于聚合酶链反应(PCR)从肾脏组织中检测真菌DNA序列,分别检测到了[具体真菌种类1]和[具体真菌种类2]。当免疫功能低下的宿主发生AKI时,应考虑真菌性间质性肾炎的鉴别诊断。此外,基于PCR从肾脏标本中检测真菌DNA序列有助于快速诊断。