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Text
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URL Address
<a href="http://doi.org/10.15171/jnp.2017.09" target="_blank" rel="noreferrer noopener">http://doi.org/10.15171/jnp.2017.09</a>
Pages
53–57
Issue
2
Volume
6
Dublin Core
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Title
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Infection associated acute interstitial nephritis; a case report.
Publisher
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Journal of nephropathology
Date
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2017
2017-03
Subject
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Acute interstitial nephritis; Dental abscess; Drug induced AIN; Infection associated AIN
Creator
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Raina Rupesh; Ale Shirisha; Chaturvedi Tushar; Fraley Luke; Novak Robert; Tanphaichitr Natthavat
Description
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BACKGROUND: Acute interstitial nephritis (AIN) is a clinico-pathological syndrome associated with a variety of infections, drugs, and sometimes with unknown causes. It is a common cause of acute kidney injury (AKI) and subsequent renal impairment, which often times is under-diagnosed. Infection-associated AIN occurs as a consequence of many systemic bacterial, viral, and parasitic infec-tions; however, its incidence has decreased significantly after the advent of antimicrobials. Infection-associated AIN presents with both oliguric or non-oliguric renal insufficiency, without the classical clinical triad of AIN (fever, rash, and arthralgia). In this scenario the renal function is usually reversible after the infection is treated. In most cases, patients with acute renal failure present with extra-renal manifestations typically detected in underlying infections. Renal biopsy serves as the most definitive test for both the diagnosis and prognosis of AIN. CASE PRESENTATION: In this paper, we will address one such case of biopsy-proven AIN. In this case, the patient presented with severe AKI induced by anaerobic streptococcus, leading to a periodontal abscess, which was successfully treated with corticosteroids and requiring renal replacement therapy (RRT). CONCLUSIONS: AIN should be considered in the differential for unexplained AKI. Initial management should include conservative therapy by withdrawing any suspected causative agent. Renal biopsy is needed for confirmation in cases where kidney function fails to improve within 5-7 days on conservative therapy. Risk of immunosuppression is very important to consider when giving steroids in patients with infection induced AIN, and steroids may have to be delayed until the active infection is completely controlled.
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<a href="http://doi.org/10.15171/jnp.2017.09" target="_blank" rel="noreferrer noopener">10.15171/jnp.2017.09</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Acute interstitial nephritis
Ale Shirisha
Chaturvedi Tushar
Dental abscess
Department of Internal Medicine
Drug induced AIN
Fraley Luke
Infection associated AIN
Journal of nephropathology
NEOMED College of Medicine
Novak Robert
Raina Rupesh
Tanphaichitr Natthavat