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Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis

Acute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can b...

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Detalles Bibliográficos
Autores principales: Schwartz, Benjamin A., Kidd, Jason M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729243/
https://www.ncbi.nlm.nih.gov/pubmed/33319204
http://dx.doi.org/10.1016/j.xkme.2020.07.009
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author Schwartz, Benjamin A.
Kidd, Jason M.
author_facet Schwartz, Benjamin A.
Kidd, Jason M.
author_sort Schwartz, Benjamin A.
collection PubMed
description Acute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can be clinically observed as glycosuria, eosinophilia, leukocytes or white blood cell casts, and proteinuria. We present a case of an otherwise healthy woman in her 30s with AIN presenting with acute kidney injury and glycosuria without pyuria. This patient had an atypical presentation of AIN that lacked classic diagnostic laboratory features and has been rarely reported. She had profound glycosuria in the setting of normoglycemia, which resolved following a course of corticosteroids. Glycosuria was most likely due to proximal tubule damage from AIN. This case supports previous hypotheses that drug-induced AIN can cause proximal tubule dysfunction resulting in glycosuria in the absence of other identifiable proximal tubule dysregulations. We hypothesize that resolution of AIN involves the repair and restoration of sodium-dependent glucose cotransporter function.
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spelling pubmed-77292432020-12-13 Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis Schwartz, Benjamin A. Kidd, Jason M. Kidney Med Case Report Acute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can be clinically observed as glycosuria, eosinophilia, leukocytes or white blood cell casts, and proteinuria. We present a case of an otherwise healthy woman in her 30s with AIN presenting with acute kidney injury and glycosuria without pyuria. This patient had an atypical presentation of AIN that lacked classic diagnostic laboratory features and has been rarely reported. She had profound glycosuria in the setting of normoglycemia, which resolved following a course of corticosteroids. Glycosuria was most likely due to proximal tubule damage from AIN. This case supports previous hypotheses that drug-induced AIN can cause proximal tubule dysfunction resulting in glycosuria in the absence of other identifiable proximal tubule dysregulations. We hypothesize that resolution of AIN involves the repair and restoration of sodium-dependent glucose cotransporter function. Elsevier 2020-11-02 /pmc/articles/PMC7729243/ /pubmed/33319204 http://dx.doi.org/10.1016/j.xkme.2020.07.009 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Schwartz, Benjamin A.
Kidd, Jason M.
Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title_full Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title_fullStr Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title_full_unstemmed Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title_short Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
title_sort glycosuria and acute kidney injury: a rare presentation of acute interstitial nephritis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729243/
https://www.ncbi.nlm.nih.gov/pubmed/33319204
http://dx.doi.org/10.1016/j.xkme.2020.07.009
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