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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...

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Autores principales: Torigoe, Kenta, Yoshida, Yuki, Sakamoto, Ryosuke, Abe, Shinichi, Muta, Kumiko, Arai, Hideyuki, Mukae, Hiroshi, Nishino, Tomoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2023
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.
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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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