Ellis D, Fried W A, Yunis E J, Blau E B
Pediatrics. 1981 Jun;67(6):862-70.
Clinical and pathologic data of 13 children, aged 5 to 16 years, with acute interstitial nephritis (AIN) are presented. The cause of AIN in these children was assessed as being related to infection in ten and methicillin in one; no infection, drug, or toxin could be implicated in two other patients. In addition to having various degrees of acute renal failure, all patients had systemic symptoms, most common of which were fatigue, fever, sore throat, and gastrointestinal disturbances. In six patients, the diagnosis of AIN was clinically suspected on the basis of tubular dysfunction such as low urinary specific gravity and glucosuria; in seven others the diagnosis was made after examination of the renal biopsy. Two patients had the nephrotic syndrome which resolved only after cytotoxic agents were added to corticosteroid therapy. The remaining 11 patients were given supportive therapy including peritoneal dialysis in one case. Complete recovery of renal function occurred in all patients within a mean interval of 69.5 +/- 34.7 days from the onset of symptoms, and all patients continue to have normal renal function during a follow-up period ranging from 1.5 to 10 years. We conclude that, in children, AIN is underdiagnosed, is most often associated with streptococcal infection, and carries an excellent prognosis.
本文介绍了13名年龄在5至16岁之间患有急性间质性肾炎（AIN）儿童的临床和病理数据。这些儿童中，AIN的病因被评估为10例与感染有关，1例与甲氧西林有关；另外2例患者未发现感染、药物或毒素相关因素。除了有不同程度的急性肾衰竭外，所有患者均有全身症状，最常见的是疲劳、发热、咽痛和胃肠道紊乱。6例患者根据肾小管功能障碍如低尿比重和糖尿在临床上怀疑为AIN；另外7例患者在肾活检检查后确诊。2例患者患有肾病综合征，仅在糖皮质激素治疗中加用细胞毒性药物后才缓解。其余11例患者接受了支持治疗，其中1例进行了腹膜透析。所有患者肾功能均在症状出现后平均69.5±34.7天完全恢复，并且在1.5至10年的随访期内所有患者肾功能持续正常。我们得出结论，在儿童中，AIN常被漏诊，最常与链球菌感染相关，且预后良好。
