De Pascalis Antonio, Buongiorno Erasmo
Nephrology, Dialysis and Renal Transplantation Unit, V. Fazzi Hospital, Lecce, Italy.
Clin Pract. 2011 Dec 30;2(1):e6. doi: 10.4081/cp.2012.e6. eCollection 2012 Jan 1.
Acute interstitial nephritis is a relevant cause of acute renal failure. Drugs are the predominant cause, followed by infections and idiopathic lesions. Acute interstitial nephritis as a form of hypersensitivity reaction is an uncommon manifestation in the setting of human parasitic infections. We present a case of acute interstitial nephritis in association with Giardia infection in a 54-year-old woman who developed an impairment of renal function after a prolonged period of slight fever and diarrhea. After an attempt to recover renal impairment by vigorous rehydratation, because of the unclear origin of the persisting renal failure, a percutaneous renal biopsy was performed and a diagnosis of severe acute interstitial nephritis was made. Steroid therapy was started and after six weeks, renal function had completely recovered. In cases of unexplained renal failure in patients affected by parasitic infections, interstitial nephritis should be considered and it is our opinion that a renal biopsy should be always performed.
急性间质性肾炎是急性肾衰竭的一个相关病因。药物是主要病因,其次是感染和特发性病变。急性间质性肾炎作为一种超敏反应形式,在人类寄生虫感染情况下是一种不常见的表现。我们报告一例54岁女性急性间质性肾炎合并贾第虫感染的病例,该患者在长期低热和腹泻后出现肾功能损害。由于持续肾衰竭的病因不明,在尝试通过积极补液恢复肾功能损害后,进行了经皮肾活检,诊断为严重急性间质性肾炎。开始使用类固醇治疗,六周后肾功能完全恢复。在寄生虫感染患者出现不明原因肾衰竭的情况下,应考虑间质性肾炎,我们认为应始终进行肾活检。