Nephrology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.
IDIBELL Biomedical Research Institute, Hospitalet de Llobregat, 08907 Barcelona, Spain.
Int J Mol Sci. 2021 Feb 26;22(5):2326. doi: 10.3390/ijms22052326.
Acute kidney injury in patients who suffer a malignancy is a common complication. Due to its high prevalence and effective treatment, one of the most frequent causes that both oncologists and nephrologists must be aware of is acute tubulointerstitial nephritis (ATIN). ATIN is an immunomediated condition and the hallmark of the disease, with the presence of a tubulointerstitial inflammatory infiltrate in the renal parenchyma. This infiltrate is composed mainly of T lymphocytes that can be accompanied by macrophages, neutrophils, or eosinophils among other cells. One of the major causes is drug-related ATIN, and some antineoplastic treatments have been related to this condition. Worthy of note are the novel immunotherapy treatments aimed at enhancing natural immunity in order to defeat cancer cells. In the context of the immunosuppression status affecting ATIN patients, some pathogen antigens can trigger the development of the disease. Finally, hematological malignancies can also manifest in the kidney leading to ATIN, even at the debut of the disease. In this review, we aim to comprehensively examine differential diagnosis of ATIN in the setting of a neoplastic patient.
患有恶性肿瘤的患者发生急性肾损伤是一种常见的并发症。由于其高患病率和有效的治疗方法，肿瘤科医生和肾病科医生都必须了解的最常见原因之一是急性肾小管间质性肾炎（ATIN）。ATIN 是一种免疫介导的疾病，其特征是肾实质中存在肾小管间质性炎症浸润。这种浸润主要由 T 淋巴细胞组成，其中可伴有巨噬细胞、中性粒细胞或嗜酸性粒细胞等其他细胞。主要原因之一是与药物相关的 ATIN，一些抗肿瘤治疗与这种情况有关。值得注意的是，旨在增强天然免疫以战胜癌细胞的新型免疫疗法。在影响 ATIN 患者的免疫抑制状态的背景下，一些病原体抗原可引发疾病的发展。最后，血液系统恶性肿瘤也可在肾脏中表现出来，导致 ATIN，甚至在疾病的首发时。在这篇综述中，我们旨在全面检查肿瘤患者中 ATIN 的鉴别诊断。
