Massive eosinophilic infiltration in a patient with the nephrotic syndrome and drug-induced interstitial nephritis

Hirofumi Makino, Toshinori Haramoto, Toru Sasaki, Kazue Hironaka, Kenichi Shikata, Kiyoshi Takahashi, Zensuke Ota

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The pathologic feature of acute interstitial nephritis is the infiltration of mononuclear cells, predominantly lymphocytes and monocytes, into the interstitium. We present an unusual case of a 49-year-old man with drug-induced acute interstitial nephritis whose renal biopsy specimen showed a massive infiltration of eosinophils into the interstitium and eosinophils infiltrating into the glomerulus through a gap in Bowman's capsule and the juxtaglomerular zone. The patient initially was referred to us with a recurrence of the nephrotic syndrome. Deterioration of renal function and an increase in proteinuria was noted at that time. Triazolam, a sleep inducer, was the suspected cause of the acute interstitial nephritis. Renal biopsy revealed sclerotic glomeruli containing eosinophils among massive infiltrated eosinophils and a loss of endothelial cells and mesangial cells in contrast to a preservation of epithelial cells. Infiltrating eosinophils were directly attached to the glomerular basement membrane, and free granules from the eosinophils were observed in the capillary lumen. In addition to chronic sclerotic change, eosinophils may have further damaged the glomerular capillary wall, leading to an increased severity of proteinuria in this case.

Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume26
Issue number1
DOIs
Publication statusPublished - Jul 1995

Keywords

  • Acute interstitial nephritis
  • drug sensitivity
  • eosinophils
  • focal segmental glomerulosclerosis
  • nephrotic syndrome
  • proteinuria

ASJC Scopus subject areas

  • Nephrology

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