Acute Interstitial Nephritis Flashcards
characteristic finding on biopsy that indicates AIN
white blood cells in kidney biopsy
which one is the normal biopsy and which one was the acute interstitial nephritis biopsy
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cause of injury in AIN:
___ blood cells go into the interstitium and cause inflammation. This mechanism of __ __ involves T cells and __ infiltrating the interstitial compartment. by definition, there should be no antibodies seen in this injury.
WHITE blood cells go into the interstitium and cause inflammation. This mechanism of CELLULAR IMMUNITY involves T cells and MONOCYTES infiltrating the interstitial compartment. by definition, there should be no antibodies seen in this injury.
T/F you would see antibodies in a bipsy of someone with AIN
false. you would see T cells and monocytes, but no antibodies
Broad causes of AIN
drugs
infections
AI disorders
tubular obstruction
idiopathic
most common cause of AIN
drugs. NSAIDS and Antibiotics. causes 70% of cases. this is due to allergic immune activation and is dose independent.
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T/F if. you overdose on NSAIDS, you will get AIN
false. drug induced AIN this is due to allergic immune activation and is dose independent.
common bacteria causes of AIN
streptococcus
legionella
leptospirosis
common viral causes of AIN
– if youre immunocompromised
- EBV, CMV or polyoma viruses (in any person, but mainyl IC)
autoimmune diseases cause 5% of cases of AIN. What diseases are they?
- lupus
- sjogren
- sarcoidosis
- can be confined to the kidney
Tubular obstruction is rarely a cause of AIN, but if it does happen, what usually is seen on labs and U/S as causes?
- cast nephropathy in multiple myeloma
- uric acid nephropathy tumor lysis syndrome
- calcium oxalate deposition - ethylene glycol toxicity
Physical exam findings Trio that should make you have a “high index of suspicion” for AIN
- rash
- fever
- eosinophilia
- only 10% have all three.
__ ___ ___ casts are pathognomonic. You may also see___uria, urine ___, and tubular dysfunction resulting in renal tubular ____. A ___ ____ is usually required for actual diagnosis.
White Blood Cell casts are pathognomonic. You may also see pyuria, urine eosinophils, and tubular dysfunction resulting in renal tubular acidosis. A Kidney Biopsy is usually required for actual diagnosis.
May also see an electrolyte disorder
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General Treatment:
- Treat the __ __
- For drug induced AIN, consider __ Prognosis is dependent on the __
- Most recover, but __ is common
General Treatment:
Treat the underlying condition
For drug induced AIN, consider corticosteroids Prognosis is dependent on the cause
Most recover, but CKD is common
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