1/138. Renal granulomatous sarcoidosis in childhood: a report of 11 cases and a review of the literature.We analysed retrospectively 11 children with renal granulomatous sarcoidosis confirmed by renal histology in order to describe the course and prognosis of the disease. Symptomatic sarcoidosis was diagnosed at a mean age of 10.1 years. Nine children had renal involvement at the time of diagnosis. In the course of the disease, nine patients developed renal failure and mild proteinuria, seven had transient sterile leukocyturia, four showed microscopic haematuria, seven had a urinary concentrating defect, and enlarged kidneys were seen in three patients. One child had hypercalcaemia and hypercalciuria, none had hypertension. light microscopy of the kidney showed interstitial infiltration by mononuclear cells in all children, interstitial fibrosis in nine patients, epithelioid granulomas in seven, tubular involvement in eight, and mild glomerular involvement in seven patients. Renal immunofluorescence was negative. Ten children received prednisone for 1-11 years. After a mean follow up of 5.5 years, three patients had entered end-stage renal failure and one had chronic insufficiency after interruption of medical supervision and prednisone therapy. CONCLUSION: Renal failure, proteinuria, leukocyturia, haematuria, and concentration defect are the prominent features of renal granulomatous sarcoidosis in children. Steroid therapy, adjusted according to disease activity, may prevent end-stage renal failure.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
2/138. Granulomatous interstitial nephritis in extrapulmonary sarcoidosis.sarcoidosis is a multisystem disorder in which the lungs or intrathoracic lymph nodes are involved in more than 90% of patients with the disease. It occasionally involves kidneys most commonly due to disordered calcium metabolism. Granulomatous interstitial nephritis is a distinct renal pathology in sarcoidosis. Renal dysfunction due to granulomatous interstitial nephritis is rare. We recently encountered a sarcoidosis patient without hypercalcemia and any evidence of pulmonary involvement which is distinctly unusual.- - - - - - - - - - ranking = 58.934424093053keywords = interstitial nephritis, nephritis, interstitial (Clic here for more details about this article) |
3/138. Acute eosinophilic interstitial nephritis and uveitis (TINU syndrome) associated with granulomatous hepatitis.A 23-year-old male presented with renal failure, cholestatic liver enzyme elevation and uveitis. Percutaneous renal biopsy revealed marked eosinophilic infiltration of the renal interstitium, which made the diagnosis of TINU syndrome (Tubulo-Interstitial Nephritis and uveitis). Percutaneous liver biopsy showed granulomatous hepatitis, which was not described as a part of TINU syndrome. The diagnostic dilemma and the literature are discussed.- - - - - - - - - - ranking = 39.289616062035keywords = interstitial nephritis, nephritis, interstitial (Clic here for more details about this article) |
4/138. Ultrasonic demonstration of xanthogranulomatous pyelonephritis.An ultrasound examination performed on a young woman with a long history of urinary tract infection demonstrated multiple subcapsular sonolucencies suggestive of multiple abscesses. The combination of the ultrasonic appearance, the clinical history, and a large nonfunctioning kidney with calculi on intravenous pyelography allowed us to suggest the diagnosis of xanthogranulomatous pyelonephritis. Ultrasound plays an even greater role in patients who are allergic to iodinated contrast material in whom intravenous pyelograms and arteriograms may be contraindicated.- - - - - - - - - - ranking = 18.619900989116keywords = nephritis (Clic here for more details about this article) |
5/138. Interstitial granulomatous dermatitis with plaques.We report on the clinical and histopathologic findings of four patients who had asymptomatic, erythematous to violaceous plaques symmetrically distributed on the upper aspect of the thighs, lateral chest, and in two cases also on the abdomen and flexor surface of the elbows. All of the patients were women; two of them had arthritis, which in one case was associated with an autoimmune disorder, and another had autoimmune thyroiditis. Histopathologically, all cases showed similar changes consisting of an interstitial granulomatous dermatitis involving mostly the lower reticular dermis. histiocytes were the predominant cellular component, arranged interstitially and in small palisades around foci of degenerated collagen bundles in concert with large numbers of neutrophils and eosinophils. Interstitial granulomatous dermatitis can present different clinical expressions, including linear cords, papules, and, as in our cases, plaques. This peculiar histopathologic pattern falls into the spectrum of cutaneous extravascular necrotizing granuloma, a condition that is often associated with systemic autoimmune disease.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
6/138. Granulomatous nephritis as a complication of intrarenal bacille Calmette-Guerin therapy.A case of granulomatous nephritis after intrarenal bacille Calmette-Guerin (BCG) therapy is reported. High fever greater than 38.5 degrees C lasted for 1 month, without response to conservative therapy. Standard nephroureterectomy was subsequently carried out. Histopathologic findings from the surgical specimen were compatible with BCG-induced granulomatous nephritis. The use of a syringe pump for retrograde instillation of BCG was thought to be the major cause of this severe complication.- - - - - - - - - - ranking = 22.343881186939keywords = nephritis (Clic here for more details about this article) |
7/138. Bilateral xanthogranulomatous perinephritis without renal parenchymal involvement.A case of isolated bilateral xanthogranulomatous perinephritis, which presented as a symmetrical irregular perirenal rim of soft tissue, is reported. Differential diagnosis and image features on ultrasound, computed tomography, and magnetic resonance are discussed.- - - - - - - - - - ranking = 18.619900989116keywords = nephritis (Clic here for more details about this article) |
8/138. Granulomatous tubulointerstitial nephritis in the renal allograft.Granulomatous tubulointerstitial nephritis has rarely been described in renal allografts. Of 1,574 renal allograft tissue specimens obtained from 514 patients in the period 1993 to 1998, we report three cases (0.6%) with interstitial nephritis containing multiple noncaseating granulomas. biopsy specimen 1 was obtained from a 44-year-old woman with a 6-day history of systemic candida albicans infection and showed multiple granulomas containing budding yeasts. biopsy specimen 2 was from a 33-year-old man who presented with miliary spread of mycobacterium tuberculosis 12 days before the allograft biopsy. biopsy specimen 3 was from a 23-year-old woman who presented with escherichia coli urinary infection and bacteremia that was treated with antibiotics for 10 days before the biopsy. Granulomatous inflammation in reponse to infectious agents or drugs in immunosuppressed kidney transplant recipients can rarely give rise to allograft interstitial nephritis that is distinct from acute rejection. To our knowledge, there are no prior reports of granulomatous tubulointerstitial nephritis associated with C albicans and E coli infection or antibiotic therapy in human renal allografts.- - - - - - - - - - ranking = 82.134604243522keywords = interstitial nephritis, nephritis, interstitial, tubulointerstitial, tubulointerstitial nephritis (Clic here for more details about this article) |
9/138. Wegener's granulomatosis in the upper respiratory tract.Wegener's granulomatosis is a distinct clinico-pathological entity characterised by necrotising vasculitis of small arteries and veins in conjunction with the formation of granuloma in the upper and lower respiratory tracts, and glomerulonephritis. The vast majority of patients have antineutrophil cytoplasmic antibodies in the serum with a characteristic cytoplasmic pattern. However, in early phases of the disease only the upper respiratory tract may be affected, clinical and histological features may be nonspecific, and antineutrophil cytoplasmic antibodies not present. In this paper we present four patients with involvement of the upper respiratory tract suspicious for early Wegener's granulomatosis. We emphasise the significance of clinical, histological and serological parameters in the early detection of Wegener's granulomatosis.- - - - - - - - - - ranking = 3.7239801978232keywords = nephritis (Clic here for more details about this article) |
10/138. Acute granulomatous interstitial nephritis and colitis in anticonvulsant hypersensitivity syndrome associated with lamotrigine treatment.We present the case of a 17-year-old woman with a history of bipolar disorder, who developed a clinical syndrome manifested by fever, lymphadenopathy, skin rash, diarrhea, and acute renal failure requiring dialysis after the use of lamotrigine. Renal biopsy showed acute interstitial nephritis (AIN) with focal granulomas. Similarly, colonic biopsy specimens showed colitis and ileitis with non-necrotizing epithelioid granulomas. The patient had a complete recovery after withdrawal of the medication and steroid treatment. Although lamotrigine has been previously implicated in the development of anticonvulsant hypersensitivity syndrome, there have been no previous reports of acute granulomatous interstitial nephritis or colitis associated with the use of this drug.- - - - - - - - - - ranking = 58.934424093053keywords = interstitial nephritis, nephritis, interstitial (Clic here for more details about this article) |
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