Acute Eosinophilic Granulomatous Tubulointerstitial Nephritis in a Patient Receiving Combination Treatment with Three Drugs.

IF 1.1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL Internal Medicine Pub Date : 2025-07-01 Epub Date: 2024-12-05 DOI:10.2169/internalmedicine.4518-24

Masatoshi Yoshimoto, Eiko Hasegawa, Yuki Oba, Hiroki Mizuno, Shigekazu Kurihara, Noriko Inoue, Akinari Sekine, Kiho Tanaka, Masayuki Yamanouchi, Tatsuya Suwabe, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Yutaka Yamaguchi, Takehiko Wada, Naoki Sawa, Yoshifumi Ubara

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Abstract

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.

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三药联合治疗急性嗜酸性肉芽肿性肾小管间质性肾炎1例。

我们在此报告一位69岁的急性肾损伤患者，他在接受三种药物诱导淋巴细胞刺激试验阳性药物的联合治疗后需要透析。肾活检显示肾小管间质性肾炎伴严重嗜酸性粒细胞浸润和大量肉芽肿形成。诊断为急性嗜酸性肉芽肿性小管间质性肾炎。嗜酸性肉芽肿合并多血管炎被排除，因为没有血管炎或血清抗嗜中性粒细胞细胞质抗体的证据，也没有过敏史。没有临床表现提示结节病。基于以上结果，我们认为该疾病是由这三种药物引起的。经糖皮质激素治疗，肾功能恢复正常。

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.