Tubulointerstitial Nephritis

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 526 Tubulointerstitial Nephritis

Tubulointerstitial nephritis (TIN, also called interstitial nephritis) is the term applied to conditions characterized by tubulointerstitial inflammation and damage with relative sparing of glomeruli and vessels. Both acute and chronic primary forms exist. Interstitial nephritis can also be present with primary glomerular diseases as well as systemic diseases affecting the kidney.

Acute Tubulointerstitial Nephritis

Pathogenesis and Pathology

The hallmarks of acute TIN are lymphocytic infiltration of the tubulointerstitium, tubular edema, and varying degrees of tubular damage. Eosinophils may be present, especially in drug-induced TIN; occasionally, granulomas occur. The pathogenesis is not fully understood, but a T cell–mediated immune mechanism has been postulated. A large number of medications, especially antimicrobials, anticonvulsants, and analgesics, have been implicated as etiologic agents (Table 526-1). Other causes include infections, primary glomerular diseases, and systemic diseases such as systemic lupus erythematosus (SLE).