Interstitial Nephritis

Question 1

What is the most common cause of interstitial nephritis?

Answer 1

Immune mediated reaction to a medication is the most common cause
2.SLE can also cause IN

Question 2

What is the pathogenesis of drug induced IN?

Answer 2

The offending drug is thought to act as a hapten and bind to components of tubular epithelial cells and elicit an immune response

Question 3

What are the categories of immune response that IN falls under?

Answer 3

Type I and Type IV

Question 4

What are the cell types present in Type I IN?

Answer 4

1. osinophils and neutrophils, some patients have elevated IgE
2. In other cases interstitial inflammation is rich in Macrophages, sometimes giant cells and granulomas

Question 5

What is the average time span between beginning drug administration and onset of disease?

Answer 5

15 Days

Question 6

What are the clinical symptoms of IN.

Answer 6

1. Oliguria
2. Fever
3. peripheral blood eosinophilia
4. Skin Rash
5. Hematuria

Question 7

What is the classic triad of IN?

Answer 7

1. Fever
2. Rash
3. Eosinophilia

Question 8

What is the classic presentation of IN?

Answer 8

1. Rise in creatinine
2. very mild to moderate proteinuria
3. Urine sediment
   - White blood cells
   - Red Blood cells
   - White cell casts

Question 9

What is the treatment for IN?

Answer 9

Withdrawal of the offending drug

2.Some patients may require Dialysis

Question 10

What is analgesic nephropathy?

Answer 10

Chronic interstitial nephritis and papillary necrosis usually in elderly females with long term combination analgesic use.