Cryptococcal granulomatous interstitial nephritis and dissemination in a patient with untreated lupus nephritis

David, Vinoi George; Korula, Anila; Choudhrie, Lisa; Michael, Joy Sarojini; Jacob, Shibu; Jacob, C. K.; John, George T.

doi:10.1093/ndt/gfp293

Cited by 8 publications

(2 citation statements)

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“…Prior to this there were a few case reports from India. [78910] There were five publications of case series of GIN. Recently, there was a review of GIN in allografts.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous interstitial nephritis: Our experience of 14 patients

et al. 2013

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Granulomatous interstitial nephritis (GIN) is a rare condition. Drugs, infections, immune processes, and foreign body reaction are the main causes. We identified a total of 14 patients with GIN during a period of 13 years in 2798 renal biopsies. There were 8 males and 6 females in the age range of 20-70 (mean 35 ± 12) years. The serum creatinine at presentation was 6.7 ± 3.8 (range: 2.3-14.7) mg/dl. In nine patients tuberculosis was the causative agent. Drugs (n = 2) and Wegener's granulomatosis (n = 1) were other etiologies. Systemic lupus erythematosis (SLE) and Immunoglobulin A nephropathy (IgAN) were seen in one patient each. Patients with tuberculosis were treated with antituberculous therapy and three of them improved. Four out of six patients who required dialysis at presentation remained dialysis dependent, one of whom underwent renal transplantation. Two patients progressed to end stage renal disease after 7 years and 9 years each. The patients with drug induced GIN had improvement in renal function after prednisolone treatment. Patients with SLE, and Wegener's granulomatosis responded to immunosuppression. Patient with IgAN was on conservative management. Finally, six patients were on conservative management for chronic renal failure.

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“…Prior to this there were a few case reports from India. [78910] There were five publications of case series of GIN. Recently, there was a review of GIN in allografts.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous interstitial nephritis: Our experience of 14 patients

et al. 2013

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“…[ 21 ] reported two cases of fungal GIN related to Trichosporon laibachii in one patient treated with chemotherapy for pharyngeal cancer and the second related to Candida albicans in a patient treated with steroids for asthma. Another report describes a patient with untreated systemic lupus erythematosis with CD4 lymphopenia who developed cryptococcal GIN [ 22 ]. These cases highlight the consideration of fungal interstitial nephritis in immunocompromised patients.…”

Section: Common Causes Of Ginmentioning

confidence: 99%

Granulomatous interstitial nephritis

2015

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Granulomatous interstitial nephritis (GIN) is a rare entity detected in ∼0.5–0.9% of all renal biopsies. GIN has been linked to several antibiotics such as cephalosporins, vancomycin, nitrofurantoin and ciprofloxacin. It is also associated with NSAIDs and granulomatous disorders such as sarcoidosis, tuberculosis, fungal infections, and granulomatosis with polyangiitis. Renal biopsy is critical in establishing this diagnosis, and the extent of tubular atrophy and interstitial fibrosis may aid in determining prognosis. Retrospective data and clinical experience suggest that removal of the offending agent in conjunction with corticosteroid therapy often results in improvement in renal function. We describe a patient with a history of multiple spinal surgeries complicated by wound infection who presented with confusion and rash with subsequent development of acute kidney injury. Urinalysis demonstrated pyuria and eosinophiluria, and renal biopsy revealed acute interstitial nephritis with granulomas. These findings were attributed to doxycycline treatment of his wound infection. This review explores the clinical associations, presentation, diagnosis, and treatment of this uncommon cause of acute kidney injury.

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Milestones in Medical Mycology in India

Gugnani

2021

Progress in Mycology

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Cryptococcal granulomatous interstitial nephritis and dissemination in a patient with untreated lupus nephritis

Cited by 8 publications

References 8 publications

Granulomatous interstitial nephritis: Our experience of 14 patients

Granulomatous interstitial nephritis: Our experience of 14 patients

Granulomatous interstitial nephritis

Milestones in Medical Mycology in India

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