Itoh Naohiro, Kasuno Kenji, Yasutomi Motoko, Kamekawa Shohei, Itoh Izumi, Hayashi Taihei, Naito Tatsushi, Imamura Yoshiaki, Nakamoto Yasunari, Ohshima Yusei
Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, Japan.
Department of Nephrology, Faculty of Medical Sciences, University of Fukui, Japan.
Intern Med. 2025 Jul 1;64(13):1979-1983. doi: 10.2169/internalmedicine.4335-24. Epub 2024 Dec 19.
Granulomatous interstitial nephritis (GIN) has been reported in <0.5% of patients with inflammatory bowel disease, and most cases of GIN are drug-induced. A 13-year-old boy was referred for the evaluation of abdominal pain, diarrhea, and weight loss. The patient was diagnosed with non-drug-induced GIN and Crohn's disease based on total colonoscopy and a biopsy of the colon and kidney. Both tissues contained macrophages and increased epithelial expression of IκBζ, a protein involved in the nuclear factor kappa-light-chain-enhancer of activated B cells pathway. There may be more patients with GIN complicated by Crohn's disease than expected, and macrophages may be involved in the pathogenesis.
肉芽肿性间质性肾炎（GIN）在炎症性肠病患者中的报告发生率低于0.5%，且大多数GIN病例是药物诱导的。一名13岁男孩因腹痛、腹泻和体重减轻前来就诊。基于全结肠镜检查以及结肠和肾脏活检，该患者被诊断为非药物诱导的GIN和克罗恩病。两种组织均含有巨噬细胞，且参与活化B细胞核因子κ轻链增强子途径的蛋白IκBζ的上皮表达增加。合并克罗恩病的GIN患者可能比预期的更多，且巨噬细胞可能参与其发病机制。
