Yoshimoto Masatoshi, Hasegawa Eiko, Oba Yuki, Mizuno Hiroki, Kurihara Shigekazu, Inoue Noriko, Sekine Akinari, Tanaka Kiho, Yamanouchi Masayuki, Suwabe Tatsuya, Kono Kei, Kinowaki Keiichi, Ohashi Kenichi, Yamaguchi Yutaka, Wada Takehiko, Sawa Naoki, Ubara Yoshifumi
Nephrology Center and the Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Department of Pathology, Toranomon Hospital, Japan.
Intern Med. 2025 Jul 1;64(13):2031-2036. doi: 10.2169/internalmedicine.4518-24. Epub 2024 Dec 5.
We herein report a 69-year-old man with acute kidney injury who required dialysis after receiving a combination of three drug-induced lymphocyte stimulation test-positive drugs. A kidney biopsy showed tubulointerstitial nephritis with severe eosinophilic infiltration and numerous granuloma formations. Acute eosinophilic granulomatous tubulointerstitial nephritis was diagnosed. Eosinophilic granulomatosis with polyangiitis was ruled out because there was no evidence of vasculitis or serum antineutrophilic cytoplasmic antibody and no history of allergy. No clinical findings were suggestive of sarcoidosis. Based on the above findings, the disease was considered to be induced by these three drugs. The renal function was normalized with glucocorticoid treatment.
我们在此报告一名69岁的急性肾损伤男性患者，在接受三种药物诱导淋巴细胞刺激试验呈阳性的药物联合治疗后需要透析。肾脏活检显示肾小管间质性肾炎，伴有严重嗜酸性粒细胞浸润和大量肉芽肿形成。诊断为急性嗜酸性粒细胞性肉芽肿性肾小管间质性肾炎。由于没有血管炎或血清抗中性粒细胞胞浆抗体的证据且无过敏史，排除了嗜酸性肉芽肿性多血管炎。没有临床发现提示结节病。基于上述发现，该疾病被认为是由这三种药物引起的。经糖皮质激素治疗后肾功能恢复正常。
