Drug-induced interstitial nephritis is a recognized cause of acute and chronic renal failure. Some of them lead to the formation of granulomata. T-cell-mediated immune response is implicated in the pathogenesis. Here, we describe the case of a 74-year-old male patient with metastatic melanoma who was referred to our clinic with a history of rash and worsening renal function. Because of subacute onset, progressively worsening renal function in the presence of skin rash, elevated liver enzymes, and in the background of exposure, medication-induced interstitial nephritis was suspected. He received 3 doses of ipilimumab, a novel drug used in the treatment of metastatic melanoma within 3 months before the onset of renal failure. A renal biopsy was done, which showed granulomatous interstitial nephritis. Renal biopsy findings, temporal relation between renal failure and exposure to medication, and review of the literature supported a diagnosis of ipilimumab-induced renal failure. He was started on steroids, and renal function recovered in the next 1 month. Immune-related adverse reaction is one of the common side effects of ipilimumab. Ipilimumab-induced hepatitis and colitis has been previously reported in the literature. This is the first ever case report of ipilimumab-induced granulomatous interstitial nephritis.
Hyperchloremic metabolic acidosis is a known complication following ileal conduit urinary diversion, often arising from urinary reabsorption in the ileum, which leads to chloride retention and bicarbonate loss and, though often asymptomatic, can produce clinically significant symptoms, particularly in patients with underlying renal impairment. A 75-year-old woman with a history of bladder cancer underwent cystectomy with ileal conduit diversion and presented on postoperative day 47 with anorexia, hypotension, and weight loss; laboratory findings revealed hyperchloremic metabolic acidosis with elevated serum chloride. The patient's acidosis gradually improved with sodium bicarbonate and Ringer's solution, stabilizing her blood pressure, creatinine, and acid-base balance, and she was discharged with outpatient follow-up.
Background: While many studies have reported renal involvement in sarcoidosis, there is limited description of the pathological manifestations of renal sarcoidosis (RS). This study aimed to explore the standardized pathological diagnosis of RS while evaluating the relationship among pathology, clinical manifestations, and prognosis.
Methods: We conducted a retrospective, single-center study of RS in renal biopsy cases treated in our department between January 2019 and December 2023.
Protothecosis is an infectious disease caused by unicellular algae of the genus Prototheca, which are mainly known for causing mastitis in farm animals. However, there are reports of protothecosis in humans and other animals, such as dogs and cats, which develop cutaneous lesions or systemic lesions. Dogs with the systemic form generally develop bloody diarrhoea and blindness and neurological signs may also occur.
Introduction: Acute interstitial nephritis (AIN) is a significant cause of acute kidney injury, with varying etiologies and outcomes. This study aimed to examine the causes, clinical characteristics, management, and kidney outcomes in patients with biopsy-confirmed AIN.
Methods: A retrospective review was conducted on 166 patients diagnosed with AIN through kidney biopsy at Mayo Clinic between 2012 and 2023.
Background: MUC1 and UMOD pathogenic variants cause autosomal dominant tubulointerstitial kidney disease (ADTKD). MUC1 is expressed in kidney, nasal mucosa and respiratory tract, while UMOD is expressed only in kidney. Due to haplo-insufficiency ADTKD-MUC1 patients produce approximately 50% of normal mucin-1.
