Interstitiell nefrit glomerulonefrit
Interstitial nephritis
Medical condition
| Interstitial nephritis | |
|---|---|
| Acute interstitial nephritis on light microscopy | |
| Specialty | Nephrology&#; |
Interstitial nephritis, also known as tubulointerstitial nephritis, is inflammation of the area of the kidney known as the renal interstitium, which consists of a collection of cells, extracellular matrix, and fluid surrounding the renal tubules. It is also known as intestinal nephritis because the clinical picture may in some cases of acute pyelonephritis include mesenteric lymphadenitis (mostly due to use of NSAIDs). More specifically, in case of recurrent urinary tract infection, secondary infection can spread to adjacent intestine.[1] In addition to providing a scaffolding support for the tubular architecture, the interstitium has been shown to participate in the fluid and electrolyte exchange as well as endocrine functions of the kidney.[1]
There are a variety of known factors that can provoke the inflammatory process within the renal interstitium, including pharmacologic, environmental, infectious and systemic disease contributors. The spectrum of disease presentation can range from an acut
Interstitiel nefrit, akut
Diagnostiske kriterier
- Anamnese, likt giver mistanke om akut interstiel nefrit (AIN), ledsaget af forhøjet kreatinin, proteinuri/hæmaturi og eventuelt allergisk udløste fund (eksantem, eosinofili, IgE forhøjelse)
- Nyrebiopsi tillsammans med patologiske forandringer som beskrevet nedenfor
Sygehistorie
- Patienten præsenterer i reglen akut/subakut opståede, uspecifikke symptomer på akut nyresvigt såsom nedsat urinproduktion, træthed, nedsat madlyst, kvalme og opkastninger. Nogle patienter oplever led- eller muskelsmerter og feberfornemmelse1
- Evt. påvises forhøjet p-kreatinin hos en asymptomatisk patient
- Evt. ses et generaliseret hypersensitivitetssyndrom tillsammans feber, udslæt, eosinofili og oligurisk nyresvigt
- Triaden let förhöjd kroppstemperatur, udslæt og ledsmerter forekommer kun hos ca. 5 %
- Andre symptomer kan være flankesmerter alternativt makroskopisk hæmaturi
- Patienter med systemisk sygdom liksom sarkoidose, Sjögrens sygdom alternativt ANCA-associeret vasculitis vil ofte have markante ekstrarenale symptomer ( fra luftvejene)
Kliniske fund
- Der er ingen specifikke kliniske fund
Supplerende und
Interstitial nephritis
Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work.
Interstitial nephritis may be temporary (acute), or it may be long-lasting (chronic) and get worse over time.
The acute form of interstitial nephritis is most often a side effect of certain drugs.
The following can cause interstitial nephritis:
- Allergic reaction to a drug (acute interstitial allergic nephritis).
- Autoimmune disorders, such as anti-tubular basement membrane disease or Kawasaki disease.
- Infections.
- Long-term use of medicines such as acetaminophen (Tylenol), aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs). This is called analgesic nephropathy.
- Side effect of certain antibiotics such as penicillin, ampicillin, methicillin, and sulfonamide medicines.
- Side effect of other medicines such as furosemide, thiazide diuretics, omeprazole, triamterene, and allopurinol.
- Too little potassium in your blood.
- Too much calcium or uric acid in your blood.
Interstitial nephritis can cause mild to severe kidney problems, including acute kidney failure. In abou