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06-05-2009, 09:40 AM
Tubulo interstitial nephritis


Def It is an inflammation with infiltration by inflammatory cells in interstitial tissues with tubular damage of tubules but the glomeruli are spared.
˛Late extension of fibrosis increased interestitial fibrous tissue + hyalinzed glomeruli

N.B. pyelonephritis:
Pathologically, it is similar to interstitial nephritis but caused by organisms(infection).

Acute interstitial nephritis: (drug induced hypersensitivity nephritis)

-causes:
e.g. acute hypersensitivity nephritis caused by Ampicillin, sulpha, cephalosporins, rifampicin , frusemide,allopurinol&NSAID.

-Diagnosis: 1-acute renal failure.
2- manifest. Of allergy (fever - rash), arthralgia.
3- urine showing eosinophiluria& eosinophilia.
Ttt stop drugs ± short term steroid ?!.
Dialysis for A.R.F.



Causes:

-NSAID. –sickle cell anaemia.
-Lead. –Irradiation.
-Gouty nephropathy. –chronic pyelonephritis.




-Diagnosis:
-cause. – manifestation of CRF.
-usually there is polyuria due to defects in urine concentration.
Protinuria usually < 1 gm.
-salt wasting may occur.

-ttt:- -of cause.
-treated as C.R.F.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)