Balafa Olga, Liapis Georgios, Duni Anila, Xiromeriti Sophia, Kalaitzidis Rigas, Elisaf Moses
Clin Nephrol. 2015 Oct;84(4):247-50. doi: 10.5414/CN108543.
We present a case which emphasizes the importance of performing a kidney biopsy in each case of acute kidney injury (AKI) of unknown etiology. The unexpected histological diagnosis of granulomatous interstitial nephritis (GIN) is a rare cause of AKI. The main causes of GIN include drugs (NSAIDs, antibiotics), sarcoidosis, and infections (mycobacterial and fungal). In our case, a 68-year-old woman was admitted with AKI, absence of symptoms and unremarkable history, apart from coronary heart disease. Renal biopsy was performed, since history as well as clinical and laboratory data could not define a cause of AKI. A more meticulous clinical and laboratory investigation followed the histological diagnosis in order to rule out sarcoidosis, vasculitis or any other known causes of GIN. Finally the diagnosis was characterized as AKI due to idiopathic GIN. The patient responded well to corticosteroids.
我们报告了一个病例，该病例强调了在每例病因不明的急性肾损伤（AKI）中进行肾活检的重要性。肉芽肿性间质性肾炎（GIN）这一意外的组织学诊断是AKI的罕见病因。GIN的主要病因包括药物（非甾体抗炎药、抗生素）、结节病和感染（分枝杆菌和真菌）。在我们的病例中，一名68岁女性因AKI入院，除冠心病外无症状且病史无异常。由于病史以及临床和实验室数据无法确定AKI的病因，故进行了肾活检。组织学诊断后进行了更细致的临床和实验室检查，以排除结节病、血管炎或任何其他已知的GIN病因。最终诊断为特发性GIN所致的AKI。患者对皮质类固醇反应良好。
