acute tubulointerstitial nephritis
Introduction
Introduction to acute tubulointerstitial nephritis Interstitial nephritis, also known as tubulointerstitial nephritis, is a general term that affects renal interstitial (including renal tubules, blood vessels, and interstitial) disorders, and does not include conditions that can cause secondary tubular-interstitial damage, such as kidneys. Small ball nephritis and so on. Acute tubulointerstitial nephritis is a type of renal failure syndrome that mainly affects renal tubules and interstitial tissues. It is allergic to drug treatment. In most cases, only a small number of drugs (in more than 80 related drugs), the identification of drug-related causes is very important, because severe kidney damage can often be prevented or reversed, nodules Disease, legionellosis, leptospirosis, streptococcus, viral infections and certain Chinese herbal medicines may also be involved. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: Kidney damage Hyperkalemia Metabolic acidosis
Cause
Causes of acute tubulointerstitial nephritis
It is allergic to drug treatment. In most cases, only a small number of drugs (in more than 80 related drugs), the identification of drug-related causes is very important, because severe kidney damage can often be prevented or reversed, nodules Disease, legionellosis, leptospirosis, streptococcus, viral infections and certain Chinese herbal medicines may also be involved.
Prevention
Acute tubulointerstitial nephritis prevention
There is no effective preventive measure. For drug-induced, attention should be paid to drug safety.
Complication
Complications of acute tubulointerstitial nephritis Complications kidney damage hyperkalemia metabolic acidosis
1. Kidney enrichment ability disorder;
2. Kidney sodium retention disorder;
3. Kidney potassium excretion disorder;
4. Renal endocrine insufficiency and so on.
Symptom
Acute tubulointerstitial neuritis symptoms Common symptoms Tubulointerstitial nephritis edema Hyperkalemia Less urinary herpes-like rash Metabolic acidosis Proteinuria
Acute tubulointerstitial nephritis has different manifestations, but the typical manifestations are temporary acute renal failure associated with medication or infection with or without oliguria. In most cases, fever occurs, which may be accompanied by urticaria rash, which often occurs in urine sediment. White blood cells, red blood cells and white blood cell casts, but sometimes no abnormalities, >75% of cases can simultaneously appear in the blood and urine eosinophils (using Hansel staining), proteinuria is usually a small amount, induced by non-steroidal anti-inflammatory drugs The disease, typical of lack of fever, rash and eosinophilia, but often seen nephropathy range proteinuria with glomerular micro lesions (also seen in ampicillin, rifampicin, interferon or ranitidine).
Many patients have signs of tubular dysfunction, such as polyuria (concentration defects), reduced volume (Na preservation defects), hyperkalemia (K-excretion defects), and metabolic acidosis (acid excretion defects) because interstitial edema usually Larger and excessively absorbed radioactive gallium or radionuclide-labeled white blood cells, however, a negative scan of the 67 gallium radionuclide can not rule out the diagnosis.
Examine
Examination of acute tubulointerstitial nephritis
Renal biopsy is the only method for definitive diagnosis. Indications include uncertainty in diagnosis or progression of renal failure. The glomeruli are usually normal. The earliest manifestations are interstitial edema, followed by interstitial lymphocytes, plasma cells, and eosinophilia. Cells and a small amount of neutrophil infiltration, in severe cases, inflammatory cells invade the intercellular space (tubule inflammation) lining the basement membrane of the tubule. In other specimens, secondary to methicillin, sulfonamides may be seen. The granuloma reaction of drugs, mycobacteria and fungi, the presence of non-caseous necrotizing granuloma suggests sarcoidosis, and immunofluorescence or electron microscopy rarely shows changes in pathological features.
Diagnosis
Diagnosis and diagnosis of acute tubulointerstitial nephritis
The presence or absence of interstitial fibrosis and tubule atrophy contributes to the identification of acute and chronic interstitial nephritis; tubulitis contributes to the differentiation of renal tubular necrosis.
