Néphropathie interstitielle aiguë immunoallergique néonatale : à propos d’un cas

Essid, A.; Allani-Essid, N.; Rubinsztajn, Renata; Estournet, B.; Bataille, Jacques

doi:10.1016/j.arcped.2010.08.014

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…One report describes a 3-week-old baby with drug-induced ATIN (cefotaxime and gentamicin). 6 No kidney biopsy was performed. The patient recovered upon discontinuation of antibiotics, without requiring dialysis.…”

Section: Discussionmentioning

confidence: 99%

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Severe Acute Kidney Injury and Multiple Organ Failure in a 17-Day-Old Newborn: When Pathology Makes the Difference

Gaudreault-Tremblay

Litalien

Patey

et al. 2018

Can J Kidney Health Dis

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Rationale:Acute tubulointerstitial nephritis (ATIN) in children is most commonly due to allergic drug reactions. In neonates, diagnosis of ATIN is clinically suspected and a kidney biopsy is not routinely performed.Presenting concern:A 17-day-old newborn presented with vomiting and dehydration, along with anuric acute kidney injury, severe electrolyte disturbances, hypocomplementemia, and thrombocytopenia. Abdominal ultrasound revealed bilateral nephromegaly and hepatosplenomegaly. The patient was promptly started on intravenous (IV) fluid and broad-spectrum antibiotics. His electrolyte disturbances were corrected as per standard guidelines. The rapid progressive clinical deterioration despite maximal treatment and the unclear etiology influenced the decision to proceed to a kidney biopsy. Histopathological findings revealed diffuse interstitial edema with a massive polymorphic cellular infiltrate and destruction of tubular structures, consistent with severe ATIN. Elements of thrombotic microangiopathy (TMA) were observed.Diagnosis:The clinical presentation combined with imaging and histopathological findings was suggestive of ATIN caused by a severe acute bacterial pyelonephritis.Intervention:Methylprednisolone pulses followed by oral prednisolone were administered. Antibiotics were continued for 10 days. The patient was kept on invasive mechanical ventilation and on peritoneal dialysis for 12 days.Outcome:His condition stabilized following steroid pulses. His renal function progressively improved, and renal replacement therapy was weaned off. His renal ultrasound normalized. He has maintained a normal blood pressure, urinalysis, and renal function over the past 5 years.Novel finding:This case reports a severe presentation of acute bacterial pyelonephritis in a neonate. It highlighted the involvement of complement activation in severe infectious process. Histopathological findings of ATIN and TMA played a crucial role in understanding the physiopathology and severity of the disease.

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Section: Discussionmentioning

confidence: 99%

“… 5 In neonates, ATIN has rarely been reported and is usually drug-induced. 6 We report the case of 17-day-old boy with an atypical presentation of severe AKI, visceromegaly, and multiple organ failure. The kidney biopsy confirmed an unexpected diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Severe Acute Kidney Injury and Multiple Organ Failure in a 17-Day-Old Newborn: When Pathology Makes the Difference

Gaudreault-Tremblay

Litalien

Patey

et al. 2018

Can J Kidney Health Dis

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Néphrite tubulo-interstitielle aiguë au cours d’une virose respiratoire à adénovirus et virus respiratoire syncytial

Suremain

Somrani

Bourdat-Michel

et al. 2015

Archives de Pédiatrie

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Case of iatrogenic neonatal acute kidney injury requiring dialysis and review of literature

et al. 2022

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A full-term male baby was administered furosemide and enalapril for treatment of cardiac failure secondary to a ventricular septal defect. He also received piperacillin-tazobactam and amikacin for 7 days for suspected early-onset neonatal sepsis. He developed anuria and raised creatinine and was referred with acute kidney injury (AKI)—neonatal KDIGO (Kidney Disease Improving Global Outcomes) stage 3 on day 20. Urine output and renal parameters improved after discontinuing drugs and peritoneal dialysis. This case report highlights the importance of serial monitoring of kidney function tests while using nephrotoxic drugs and ensuring correct dosage and titration. In the early stages, AKI can be treated with conservative therapy but once established, renal replacement therapy might be required. It can also lead to chronic kidney disease.

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Néphropathie interstitielle aiguë immunoallergique néonatale : à propos d’un cas

Cited by 3 publications

References 5 publications

Severe Acute Kidney Injury and Multiple Organ Failure in a 17-Day-Old Newborn: When Pathology Makes the Difference

Severe Acute Kidney Injury and Multiple Organ Failure in a 17-Day-Old Newborn: When Pathology Makes the Difference

Néphrite tubulo-interstitielle aiguë au cours d’une virose respiratoire à adénovirus et virus respiratoire syncytial

Case of iatrogenic neonatal acute kidney injury requiring dialysis and review of literature

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