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Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient
Anorexia nervosa is a psychiatric disorder that is often diagnosed in adolescents and young adults. Renal-related complications of anorexia nervosa include abnormal water metabolism, electrolyte abnormalities, and nephrocalcinosis, which may lead to irreversible renal damage. Furthermore, tubulointe...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586332/ https://www.ncbi.nlm.nih.gov/pubmed/37868329 http://dx.doi.org/10.14740/jmc4152 |
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author | Torigoe, Kenta Yoshida, Yuki Sakamoto, Ryosuke Abe, Shinichi Muta, Kumiko Arai, Hideyuki Mukae, Hiroshi Nishino, Tomoya |
author_facet | Torigoe, Kenta Yoshida, Yuki Sakamoto, Ryosuke Abe, Shinichi Muta, Kumiko Arai, Hideyuki Mukae, Hiroshi Nishino, Tomoya |
author_sort | Torigoe, Kenta |
collection | PubMed |
description | Anorexia nervosa is a psychiatric disorder that is often diagnosed in adolescents and young adults. Renal-related complications of anorexia nervosa include abnormal water metabolism, electrolyte abnormalities, and nephrocalcinosis, which may lead to irreversible renal damage. Furthermore, tubulointerstitial nephritis has been reported as a renal pathological feature of anorexia nervosa. Immunosuppressive therapy, such as with glucocorticoids, has been recommended for idiopathic interstitial nephritis treatment; however, the effectiveness of immunosuppressive therapy for interstitial nephritis in patients with anorexia nervosa remains unestablished. Here, we report a case of interstitial nephritis in a patient with anorexia nervosa whose renal function was successfully improved with glucocorticoid therapy. The patient was a 38-year-old woman who was referred for renal dysfunction (estimated glomerular filtration rate: 7.6 mL/min/1.73 m(2)). She had anorexia nervosa and repeated episodes of vomiting. Hypokalemia (K: 2.1 mEq/L) and metabolic alkalosis (HCO(3)(-): 54.2 mEq/L) were observed. Fluid therapy and potassium supplementation did not improve renal function; therefore, a percutaneous renal biopsy was performed. The renal pathology results revealed interstitial fibrosis, inflammatory cell infiltration in the interstitium, and tubulitis, suggesting a diagnosis of tubulointerstitial nephritis. Glucocorticoid therapy improved the patient’s renal function to an estimated glomerular filtration rate of 19.91 mL/min/1.73 m(2), and the renal function remained stable thereafter. This case suggests that glucocorticoid therapy may be considered for the treatment of interstitial nephritis in patients with anorexia. |
format | Online Article Text |
id | pubmed-10586332 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105863322023-10-20 Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient Torigoe, Kenta Yoshida, Yuki Sakamoto, Ryosuke Abe, Shinichi Muta, Kumiko Arai, Hideyuki Mukae, Hiroshi Nishino, Tomoya J Med Cases Case Report Anorexia nervosa is a psychiatric disorder that is often diagnosed in adolescents and young adults. Renal-related complications of anorexia nervosa include abnormal water metabolism, electrolyte abnormalities, and nephrocalcinosis, which may lead to irreversible renal damage. Furthermore, tubulointerstitial nephritis has been reported as a renal pathological feature of anorexia nervosa. Immunosuppressive therapy, such as with glucocorticoids, has been recommended for idiopathic interstitial nephritis treatment; however, the effectiveness of immunosuppressive therapy for interstitial nephritis in patients with anorexia nervosa remains unestablished. Here, we report a case of interstitial nephritis in a patient with anorexia nervosa whose renal function was successfully improved with glucocorticoid therapy. The patient was a 38-year-old woman who was referred for renal dysfunction (estimated glomerular filtration rate: 7.6 mL/min/1.73 m(2)). She had anorexia nervosa and repeated episodes of vomiting. Hypokalemia (K: 2.1 mEq/L) and metabolic alkalosis (HCO(3)(-): 54.2 mEq/L) were observed. Fluid therapy and potassium supplementation did not improve renal function; therefore, a percutaneous renal biopsy was performed. The renal pathology results revealed interstitial fibrosis, inflammatory cell infiltration in the interstitium, and tubulitis, suggesting a diagnosis of tubulointerstitial nephritis. Glucocorticoid therapy improved the patient’s renal function to an estimated glomerular filtration rate of 19.91 mL/min/1.73 m(2), and the renal function remained stable thereafter. This case suggests that glucocorticoid therapy may be considered for the treatment of interstitial nephritis in patients with anorexia. Elmer Press 2023-10 2023-10-13 /pmc/articles/PMC10586332/ /pubmed/37868329 http://dx.doi.org/10.14740/jmc4152 Text en Copyright 2023, Torigoe et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Torigoe, Kenta Yoshida, Yuki Sakamoto, Ryosuke Abe, Shinichi Muta, Kumiko Arai, Hideyuki Mukae, Hiroshi Nishino, Tomoya Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title | Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title_full | Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title_fullStr | Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title_full_unstemmed | Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title_short | Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient |
title_sort | improvement in tubulointerstitial nephritis with glucocorticoid therapy in an anorexia nervosa patient |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586332/ https://www.ncbi.nlm.nih.gov/pubmed/37868329 http://dx.doi.org/10.14740/jmc4152 |
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