Interstitial nephritis

Interstitial nephritis: Description, Causes and Risk Factors:ICD-10: N12Interstitial nephritis is an inflammatory disease of the renal interstitium. It may be primary or secondary and has two clinical forms, acute and chronic.Interstitial nephritisThe hallmark of acute interstitial nephritis (AIN) is the infiltration of inflammatory cells within the renal interstitium, with associated edema, sparing the glomeruli and blood vessels. Interstitial fibrosis is initially sparse, but develops later in the course of the illness. Fibrotic lesions may be diffuse or patchy, beginning deep in the renal cortex, most prominently at the medullocortical junction. The inflammatory infiltrate is typically composed of mononuclear cells and T lymphocytes, with a variable number of plasma cells and eosinophils. Eosinophils may be totally absent from the infiltrate or may concentrate in small foci, forming eosinophilic microabscesses.Chronic interstitial nephritis (CIN) is characterized by focal or diffuse interstitial fibrosis accompanied by infiltration, with inflammatory cells ultimately associated with extensive tubular atrophy. It represents a nonspecific reaction to a variety of causes: analgesic abuse, lead and cadmium toxicity, nephrocalcinosis, urate nephropathy, radiation nephritis, sarcoidosis, Balkan nephritis, and some instances of obstructive uropathy.Causes and Risk Factors May include:Infectious AgentsBacteria: Legionella, Brucella, Corynebacterium diphtheriae, Streptococcus, Staphylococcus, Yersinia, Salmonella, E. coli, Campylobacter.
  • Viruses: Epstein-Barr virus (EBV), Cytomegalovirus, Hanta virus, Human immunodeficiency virus, Herpes simplex, Polyomavirus, Hepatitis B virus.
  • Other Agents: Mycoplasma, Rickettsia, Leptospira, Mycobacterium tuberculosis, Schistosoma mekongi, Toxoplasma, Chlamydia.
Hereditary Diseases:Autosomal dominant polycystic kidney disease.
  • Medullary cystic disease-juvenile nephronophthisis.
Metabolic Disturbances:Hypercalcemia/nephrocalcinosis. Immune-Mediated Disorders:Renal allograft rejection.
  • Wegener granulomatosis.
  • Sj

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