Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Pediatric Nephrology
Erschienen in: Pediatric Nephrology 4/2017

07.05.2016 | Educational Review

Tubulointerstitial nephritis: diagnosis, treatment, and monitoring

verfasst von: Emily Joyce, Paulina Glasner, Sarangarajan Ranganathan, Agnieszka Swiatecka-Urban

Erschienen in: Pediatric Nephrology | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Tubulointerstitial nephritis (TIN) is a frequent cause of acute kidney injury (AKI) that can lead to chronic kidney disease (CKD). TIN is associated with an immune-mediated infiltration of the kidney interstitium by inflammatory cells, which may progress to fibrosis. Patients often present with nonspecific symptoms, which can lead to delayed diagnosis and treatment of the disease. Etiology can be drug-induced, infectious, idiopathic, genetic, or related to a systemic inflammatory condition such as tubulointerstitial nephritis and uveitis (TINU) syndrome, inflammatory bowel disease, or immunoglobulin G4 (IgG4)-associated immune complex multiorgan autoimmune disease (MAD). It is imperative to have a high clinical suspicion for TIN in order to remove potential offending agents and treat any associated systemic diseases. Treatment is ultimately dependent on underlying etiology. While there are no randomized controlled clinical trials to assess treatment choice and efficacy in TIN, corticosteroids have been a mainstay of therapy, and recent studies have suggested a possible role for mycophenolate mofetil. Urinary biomarkers such as alpha1- and beta2-microglobulin may help diagnose and monitor disease activity in TIN. Screening for TIN should be implemented in children with inflammatory bowel disease, uveitis, or IgG4-associated MAD.
Literatur
1.
Ulinski T, Sellier-Leclerc A-L, Tudorache E, Bensman A, Aoun B (2011) Acute tubulointerstitial nephritis. Pediatr Nephrol 27:1051–1057CrossRefPubMed
2.
3.
Baker RJ, Pusey CD (2004) The changing profile of acute tubulointerstitial nephritis. Nephrol Dial Transplant 19:8–11CrossRefPubMed
4.
5.
6.
Clarkson MR (2004) Acute interstitial nephritis: clinical features and response to corticosteroid therapy. Nephrol Dial Transplant 19:2778–2783CrossRefPubMed
7.
Coppo R, Gianoglio B, Porcellini MG (1998) Frequency of renal diseases and clinical indications for renal biopsy in children (report of the Italian national registry of renal biopsies in children). Nephrol Dial Transplant 13:293–297CrossRefPubMed
8.
Greising J, Trachtman H, Gauthier B, Valderrama E (1990) Acute interstitial nephritis in adolescents and young adults. Child Nephrol Urol 10:189–195PubMed
9.
10.
Oikonomou K, Kapsoritakis A, Eleftheriadis T, Stefanidis I, Potamianos S (2011) Renal manifestations and complications of inflammatory bowel disease. Inflamm Bowel Dis 17:1034–1045CrossRefPubMed
11.
Perazella MA, Markowitz GS (2010) Drug-induced acute interstitial nephritis. Nat Rev Nephrol 6:461–470CrossRefPubMed
12.
Schubert C, Bates WD, Moosa MR (2010) Acute tubulointerstitial nephritis related to antituberculous drug therapy. Clin Nephrol 73:413–419CrossRefPubMed
13.
Nessi R, Bonoldi GL, Redaelli B, di Filippo G (1976) Acute renal failure after rifampicin: a case report and survey of the literature. Nephron 16:148–159CrossRefPubMed
14.
15.
Perazella MA (2010) Drug use and nephrotoxicity in the intensive care unit. Kidney Int 81:1172–1178CrossRefPubMed
16.
17.
Baksh FK, Finkelstein SD, Swalsky PA, Stoner GL, Ryschkewitsch CF, Randhawa P (2001) Molecular genotyping of BK and JC viruses in human polyomavirus-associated interstitial nephritis after renal transplantation. Am J Kidney Dis 38:354–365CrossRefPubMed
18.
Chang J-F, Peng Y-S, Tsai C-C, Hsu M-S, Lai C-F (2010) A possible rare cause of renal failure in streptococcal infection. Nephrol Dial Transplant 26:368–371CrossRefPubMed
19.
Ozdemir BH, Sar A, Uyar P, Suren D, Demirhan B, Haberal M (2006) Posttransplant tubulointerstitial nephritis: clinicopathological correlation. Transplant Proc 38:466–469CrossRefPubMed
20.
Richardson WP, Colvin RB, Cheeseman SH, Tolkoff-Rubin NE, Herrin JT, Cosimi AB, Collins AB, Hirsch MS, McCluskey RT, Russel PS, Rubin RH (1981) Glomerulopathy associated with cytomegalovirus viremia in renal allografts. N Engl J Med 305:57–63CrossRefPubMed
21.
Howell DN, Smith SR, Butterly DW, Klassen PS, Krigman HR, Burchette JL Jr, Miller SE (1999) Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients. Transplantation 68:1279–1288CrossRefPubMed
22.
Platt JL, Sibley RK, Michael AF (1985) Interstitial nephritis associated with cytomegalovirus infection. Kidney Int 28:550–552CrossRefPubMed
23.
Rosen S, Harmon W, Krensky AM, Edelson PJ, Padgett BL, Grinnell BW, Rubino MJ, Walker DL (1983) Tubulo-interstitial nephritis associated with polyomavirus (BK type) infection. N Engl J Med 308:1192–1196CrossRefPubMed
24.
Asim M, Chong-Lopez A, Nickeleit V (2003) Adenovirus infection of a renal allograft. Am J Kidney Dis 41:696–701CrossRefPubMed
25.
Ito M, Hirabayashi N, Uno Y, Nakayama A, Asai J (1991) Necrotizing tubulointerstitial nephritis associated with adenovirus infection. Hum Pathol 22:1225–1231CrossRefPubMed
26.
Mori K, Yoshihara T, Nishimura Y, Uchida M, Katsura K, Kawase Y, Hatano I, Ishida H, Chiyonobu T, Kasubuchi Y, Morimoto A, Teramura T, Imashuku S (2003) Acute renal failure due to adenovirus-associated obstructive Uropathy and necrotizing tubulointerstitial nephritis in a bone marrow transplant recipient. Bone Marrow Transplant 31:1173–1176CrossRefPubMed
27.
Cohen AH, Nast CC (1988) HIV-associated nephropathy. A unique combined glomerular, tubular, and interstitial lesion. Mod Pathol 1:87–97PubMed
28.
Cigni A, Soro G, Faedda R, Caucci F, Amadori F, Manca A, Tanda F, Satta AE (2003) A case of adult-onset tubulointerstitial nephritis and Uveitis (“TINU syndrome”) associated with sacroileitis and Epstein-Barr virus infection with good spontaneous outcome. Am J Kidney Dis 42:E4–10CrossRefPubMed
29.
Grefer J, Santer R, Ankermann T, Faul S, Nolle B, Eggert P (1999) Tubulointerstitial nephritis and uveitis in association with Epstein-Barr virus infection. Pediatr Nephrol 13:336–339CrossRefPubMed
30.
Yang CW, Wu MS, Pan MJ (2001) Leptospirosis renal disease. Nephrol Dial Transplant 16(Suppl 5):73–77CrossRefPubMed
31.
Pasternack A, Helin H, Vänttinen T, Jarventie G, Vesikari T (1979) Acute tubulointerstitial nephritis in a patient with mycoplasma pneumoniae infection. Scand J Infect Dis 11:85–87CrossRefPubMed
32.
Saïd MH, Layani MP, Colon S, Faraj G, Glastre C, Cochat P (1999) Mycoplasma pneumoniae-associated nephritis in children. Pediatr Nephrol 13:39–44CrossRefPubMed
33.
Kobayashi Y, Honda M, Yoshikawa N, Ito H (2000) Acute tubulointerstitial nephritis in 21 Japanese children. Clin Nephrol 54:191–197PubMed
34.
Yamaguchi Y, Kanetsuna Y, Honda K, Yamanaka N, Kawano M, Nagata M, Japanese study group on IgG4-related nephropathy (2011) Characteristic tubulointerstitial nephritis in IgG4-related disease. Hum Pathol 43:536–549CrossRefPubMed
35.
Cornell LD, Chicano SL, Deshpande V, Collins AB, Selig MK, Lauwers GY, Barisoni L, Colvin RB (2007) Pseudotumors due to IgG4 immune-complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease. Am J Surg Pathol 31:1586–1597CrossRefPubMed
36.
Saeki T, Nishi S, Imai N, Ito T, Yamazaki H, Kawano M, Yamamoto M, Takahashi H, Matsui S, Nakada S, Origuchi T, Hirabayashi A, Homma N, Tsubata Y, Takata T, Wada Y, Saito A, Fukase S, Ishioka K, Miyazaki K, Masaki Y, Umehara H, Sugai S, Narita I (2010) Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int 78:1016–1023CrossRefPubMed
37.
Uchiyama-Tanaka Y, Mori Y, Kimura T, Sonomura K, Umemura S, Kishimoto N, Nose A, Tokoro T, Kijima Y, Yamahara H, Nagata T, Masaki H, Umeda Y, Okazaki K, Iwasaka T (2004) Acute tubulointerstitial nephritis associated with autoimmune-related pancreatitis. Am J Kidney Dis 43:e18–25CrossRefPubMed
38.
Vaseemuddin M, Schwartz MM, Dunea G, Kraus MA (2006) Idiopathic hypocomplementemic immune-complex-mediated tubulointerstitial nephritis. Nat Clin Pract Nephrol 3:50–58CrossRef
39.
Clayman MD, Michaud L, Brentjens J, Andres GA, Kefalides NA, Neilson EG (1986) Isolation of the target antigen of human antitubular basement membrane antibody-associated interstitial nephritis. J Clin Invest 77:1143–1147CrossRefPubMedPubMedCentral
40.
Ikeda M, Takemura T, Hino S, Yoshioka K (2000) Molecular cloning, expression, and chromosomal localization of a human tubulointerstitial nephritis antigen. Biochem Biophys Res Commun 268:225–230CrossRefPubMed
41.
Takemura Y, Koshimichi M, Sugimoto K, Yanagida H, Fujita S, Miyazawa T, Miyazaki K, Okada M, Takemura T (2010) A tubulointerstitial nephritis antigen gene defect causes childhood-onset chronic renal failure. Pediatr Nephrol 25:1349–1353CrossRefPubMed
42.
Eckardt K-U, Alper SL, Antignac C, Bleyer AJ, Chauveau D, Dahan K, Deltas C, Hosking A, Kmoch S, Rampoldi L, Wiesener M, Wolf MT, Devuyst O (2015) Autosomal dominant tubulointerstitial kidney disease: diagnosis, classification, and management—A KDIGO consensus report. Kidney Int 88:676–683CrossRefPubMed
43.
Robles NR, Lopez-Gomez J, Garcia-Pino G, Ferreira F, Alvarado R, Sanchez-Casado E, Cubero JJ (2013) Use of α1-microglobulin for diagnosing chronic interstitial nephropathy. Clin Exp Med 14:315–320CrossRefPubMed
44.
García-Sánchez O, López-Hernández FJ, López-Novoa JM (2010) An integrative view on the role of TGF-beta in the progressive tubular deletion associated with chronic kidney disease. Kidney Int 77:950–955CrossRefPubMed
45.
Tong JE, Howell DN, Foreman JW (2006) Drug-induced granulomatous interstitial nephritis in a pediatric patient. Pediatr Nephrol 22:306–309CrossRefPubMed
46.
Joss N, Morris S, Young B, Geddes C (2007) Granulomatous interstitial nephritis. Clin J Am Soc Nephrol 2:222–230CrossRefPubMed
47.
Meehan SM, Josephson MA, Haas M (2000) Granulomatous tubulointerstitial nephritis in the renal allograft. Am J Kidney Dis 36:E27CrossRefPubMed
48.
Jahnukainen T, Ala-Houhala M, Karikoski R, Kataja J, Saarela V, Nuutinen M (2010) Clinical outcome and occurrence of Uveitis in children with idiopathic tubulointerstitial nephritis. Pediatr Nephrol 26:291–299CrossRefPubMed
49.
Cosyns JP, Jadoul M, Squifflet JP, De Plaen FJ, Ferluga D, van Ypersele de Strihou C (1994) Chinese herbs nephropathy: a clue to Balkan endemic nephropathy? Kidney Int 45:1680–1688CrossRefPubMed
50.
Tatu CA, Orem WH, Finkelman RB, Feder GL (1998) The etiology of Balkan endemic nephropathy: still more questions than answers. Environ Health Perspect 106:689–700CrossRefPubMedPubMedCentral
51.
Mackensen F, Smith JR, Rosenbaum JT (2007) Enhanced recognition, treatment, and prognosis of tubulointerstitial nephritis and Uveitis syndrome. Ophthalmology 114:995–999CrossRefPubMed
52.
Levinson RD, Mandeville J, Holland GN, Rosenbaum JT (2000) Tubulointerstitial nephritis and uveitis syndrome: recognizing the importance of an uncommon disease. Am J Ophthalmol 129:798–799CrossRefPubMed
53.
Thomassen VH, Ring T, Thaarup J, Baggesen K (2009) Tubulointerstitial nephritis and uveitis (TINU) syndrome: a case report and review of the literature. Acta Ophthalmol 87:676–679CrossRefPubMed
54.
Mandeville J, Levinson RD, Holland GN (2001) The tubulointerstitial nephritis and uveitis syndrome. Surv Ophthalmol 46:195–208CrossRefPubMed
55.
Saarela V, Nuutinen M, Ala-Houhala M, Arikoski P, Ronnholm K, Jahnukainen T (2013) Tubulointerstitial nephritis and Uveitis syndrome in children: a prospective multicenter study. Ophthalmology 120:1476–1481CrossRefPubMed
56.
Hettinga YM, Scheerlinck LME, Lilien MR, Rothova A, de Boer JH (2014) The value of measuring urinary β2-microglobulin and serum creatinine for detecting tubulointerstitial nephritis and uveitis syndrome in young patients with uveitis. JAMA Ophthalmol 133:140–145CrossRef
57.
58.
Murray N, Wakefield D (1993) Primary tubulointerstitial nephritis and uveitis syndrome. Aust N Z J Ophthalmol 21:121–122CrossRefPubMed
59.
Janda J, Rambousek V, Kolský A, Stejskal J (1990) Acute interstitial nephritis with uveitis in children and adolescents. Cesk Pediatr 45:7–11PubMed
60.
Sanchez-Burson J, Garcia-Porrua C, Montero-Granados R, Gonzalez-Escribano F, Gonzalez-Gay MA (2002) Tubulointerstitial nephritis and uveitis syndrome in Southern Spain. Semin Arthritis Rheum 32:125–129CrossRefPubMed
61.
Kanski JJ, Bowling B (2009) Clinical ophthalmology: a synopsis. Elselvier, Philadelphia
62.
Gafter U, Kalechman Y, Zevin D, Korzets A (1993) Tubulointerstitial nephritis and uveitis: association with suppressed cellular immunity. Nephrol Dial Transplant 8:821–826PubMed
63.
Auclin F, Bodard E (1988) Interstitial tubulo-nephritis and uveitis (Nitu syndrome). Apropos of a case. J Fr Ophtalmol 12:307–311
64.
Gion N, Stavrou P, Foster CS (2000) Immunomodulatory therapy for chronic tubulointerstitial nephritis–associated uveitis. Am J Ophthalmol 129:764–768CrossRefPubMed
65.
Reddy AK, Hwang Y-S, Mandelcorn ED, Davis JL (2014) HLA-DR, DQ class II DNA typing in pediatric panuveitis and tubulointerstitial nephritis and Uveitis. Am J Ophthalmol 157:678–686CrossRefPubMed
66.
Ambruzs JM, Walker PD, Larsen CP (2013) The histopathologic spectrum of kidney biopsies in patients with inflammatory bowel disease. Clin J Am Soc Nephrol 9:265–270CrossRefPubMedPubMedCentral
67.
Tokuyama H, Wakino S, Konishi K, Hashiguchi A, Hayashi K, Itoh H (2010) Acute interstitial nephritis associated with ulcerative colitis. Clin Exp Nephrol 14:483–486CrossRefPubMed
68.
Marcus SB, Brown JB, Melin-Aldana H, Strople JA (2008) Tubulointerstitial nephritis: an extraintestinal manifestation of Crohn disease in children. J Pediatr Gastroenterol Nutr 46:338–341CrossRefPubMed
69.
Poulou AC, Goumas KE, Dandakis DC, Tyrmpas I, Panagiotaki M, Gerogouli A, Soutos DC, Archimandritis A (2006) Microproteinuria in patients with inflammatory bowel disease: is it associated with the disease activity or the treatment with 5-aminosalicylic acid? World J Gastroenterol 12:739–746CrossRefPubMedPubMedCentral
70.
Herrlinger KR, Noftz MK, Fellermann K, Schmidt K, Steinhoff J, Stange EF (2001) Minimal renal dysfunction in inflammatory bowel disease is related to disease activity but not to 5-ASA use. Aliment Pharmacol Ther 15:363–369CrossRefPubMed
71.
Kreisel W, Wolf LM, Grotz W, Grieshaber M (1996) Renal tubular damage: an extraintestinal manifestation of chronic inflammatory bowel disease. Eur J Gastroenterol Hepatol 8:461–468PubMed
72.
Schreiber S, Hämling J, Zehnter E, Howaldt S, Daerr W, Raedler A, Kruis W (1997) Renal tubular dysfunction in patients with inflammatory bowel disease treated with aminosalicylate. Gut 40:761–766CrossRefPubMedPubMedCentral
73.
74.
Fraser JS, Muller AF, Smith DJ, Newman DJ, Lamb EJ (2001) Renal tubular injury is present in acute inflammatory bowel disease prior to the introduction of drug therapy. Aliment Pharmacol Ther 15:1131–1137CrossRefPubMed
75.
Pardi DS, Tremaine WJ, Sandborn WJ, McCarthy JT (1998) Renal and urologic complications of inflammatory bowel disease. Am J Gastroenterol 93:504–514CrossRefPubMed
76.
González E, Gutiérrez E, Galeano C, Chevia C, de Sequera P, Bernis C, Parra EG, Delgado R, Sanz M, Ortiz M, Goicoechea M, Quereda C, Olea T, Bouarich H, Hernandez Y, Segovia B, Praga M, Intersticiales GMDN (2008) Early steroid treatment improves the recovery of renal function in patients with drug-induced acute interstitial nephritis. Kidney Int 73:940–946CrossRefPubMed
77.
Araya CE, Lew JF, Fennell RS, Neiberger RE, Dharnidharka VR (2006) Intermediate-dose cidofovir without probenecid in the treatment of BK virus allograft nephropathy. Pediatr Transplant 10:32–37CrossRefPubMed
78.
Preddie DC, Markowitz GS, Radhakrishnan J, Nickolas TL, D’Agati VD, Schwimmer JA, Gardenswartz M, Rosen R, Appel GB (2006) Mycophenolate mofetil for the treatment of interstitial nephritis. Clin J Am Soc Nephrol 1:718–722CrossRefPubMed
79.
Jahnukainen T, Saarela V, Arikoski P, Ylinen E, Ronnholm K, Ala-Houhala M, Nuutinen M (2013) Prednisone in the treatment of tubulointerstitial nephritis in children. Pediatr Nephrol 28:1253–1260CrossRefPubMed
80.
Kenouch S, Belghiti D, Di Costanzo P (1988) A new syndrome: acute interstitial nephropathy with uveitis. Apropos of a case. Ann Med Interne (Paris) 140:169–172
81.
Pešić I, Stefanović V, Müller GA, Müller CA, Cukuranovic R, Jahn O, Bojanic V, Koziolek M, Dihazi H (2011) Identification and validation of six proteins as marker for endemic nephropathy. J Proteome 74:1994–2007CrossRef
82.
Stefanović V, Djukanović L, Cukuranović R, Bukvic D, Lezaic V, Maric I, Ogrizovic SS, Jovanovic I, Vlahovic P, Pesic I, Djordjevic V (2011) Beta2-microglobulin and alpha1-microglobulin as markers of Balkan endemic nephropathy, a worldwide disease. Ren Fail 33:176–183CrossRefPubMed
83.
Wu Y, Yang L, Su T, Wang C, Liu G, Li XM (2010) Pathological significance of a panel of urinary biomarkers in patients with drug-induced tubulointerstitial nephritis. Clin J Am Soc Nephrol 5:1954–1959CrossRefPubMedPubMedCentral
84.
Nolin TD, Himmelfarb J (2009) Mechanisms of drug-induced nephrotoxicity. Handb Exp Pharmacol 196:111–130CrossRef
85.
Perazella MA (2009) Renal vulnerability to drug toxicity. Clin J Am Soc Nephrol 4:1275–1283CrossRefPubMed
86.
Akil I, Ozguven A, Canda E, Yilmaz O, Nese N, Ozkol M, May S, Franke A, Cirak S (2010) Co-existence of chronic renal failure, renal clear cell carcinoma, and Blau syndrome. Pediatr Nephrol 25:977–981CrossRefPubMed
87.
Nakajima T, Tsujimoto I, Ujihira N, Sezaki R (2015) Tubulointerstitial nephritis caused by chronic lymphocytic leukemia. Intern Med 54:685–686CrossRefPubMed
88.
Murray T, Goldberg M (1975) Chronic interstitial nephritis: etiologic factors. Ann Intern Med 82:453–459CrossRefPubMed
Metadaten
Titel
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring
verfasst von
Emily Joyce
Paulina Glasner
Sarangarajan Ranganathan
Agnieszka Swiatecka-Urban
Publikationsdatum
07.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 4/2017
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-016-3394-5

Weitere Artikel der Ausgabe 4/2017

Pediatric Nephrology 4/2017 Zur Ausgabe

Original Article

Effect of center practices on the choice of the first dialysis modality for children and young adults

Original Article

Racial–ethnic disparities in mortality and kidney transplant outcomes among pediatric dialysis patients

Original Article

Decreased urinary excretion of the ectodomain form of megalin (A-megalin) in children with OCRL gene mutations

Brief Report

M-type phospholipase A2 receptor (PLA2R) glomerular staining in pediatric idiopathic membranous nephropathy

Clinical Quiz

Rare case of nephrocalcinosis in a 14-year-old girl: Questions

Management Dilemma

Management dilemmas in pediatric nephrology: time-limited trials of dialysis therapy

Neu im Fachgebiet Pädiatrie

23.04.2024 | Typ-1-Diabetes | Nachrichten

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

22.04.2024 | Fehlsichtigkeit | Nachrichten

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

18.04.2024 | Spinale Muskelatrophien | Nachrichten

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind
weitere anzeigen

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen