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Chapter 12 - Tubulointerstitial Diseases

Published online by Cambridge University Press:  01 March 2017

By
Shane Meehan  and
Tibor Nadasdy
Edited by
Xin Jin (Joseph) Zhou ,
Zoltan G. Laszik ,
Tibor Nadasdy  and
Vivette D. D'Agati
Xin Jin (Joseph) Zhou
Affiliation:
Baylor University Medical Center, Dallas
Zoltan G. Laszik
Affiliation:
University of California, San Francisco
Tibor Nadasdy
Affiliation:
Ohio State University
Vivette D. D'Agati
Affiliation:
Columbia University, New York
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Silva's Diagnostic Renal Pathology , pp. 449 - 486
Publisher: Cambridge University Press
Print publication year: 2017

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References

Lamiere, N, Van Biesen, W, Vanholder, R. Acute renal failure. Lancet 2005; 365: 417–30.Google Scholar
Rewa, O, Bagshaw, SM. Acute kidney injursy – epidemiology, outcome and economics. Nat Rev Nephrol 2014; 10: 193–207.Google Scholar
Solez, K, Morel-Maroger, L, Sraer, JD. The morphology of “acute tubular necrosis” in man: analysis of 57 renal biopsies and a comparison with the glycerol model. Medicine (Baltimore) 1979; 58: 362–76.Google Scholar
Redfern, A, Mahmoud, H, McCulloch, T, et al. Renal arcuate vein microthrombi-associated AKI. Clin J Am Soc Nephrol 2015; 10: 180–6.Google Scholar
Zhang, PL, Lin, F, Han, WK, Blasik, TM, Bonventre, JV. Kidney injury molecule-1 is a specific biomarker, which enables diagnosis of premortem acute tubular necrosis in the presence of autolytic artefacts in cadaver kidneys. Mod Pathol 2007; 20; 10A.Google Scholar
Brodsky, SV, Satoskar, A, Chen, J, et al. Acute kidney injury during warfarin therapy associated with obstructive tubular red blood cell casts: a report of 9 cases. Am J Kidney Dis 2009; 54: 1121–6.CrossRefGoogle Scholar
Van Slambrouck, CM, Salem, F, Meehan, SM, Chang, A. Bile cast nephropathy is a common pathologic finding for kidney injury associated with severe liver dysfunction. Kidney Int 2013; 84: 192–7.CrossRefGoogle ScholarPubMed
Herlitz, LC, Mohan, S, Stokes, MB, et al. Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological and mitochondrial abnormalities. Kidney Int 2010; 78: 1171–7.Google Scholar
Janssen, CW. Osmotic nephrosis. Acta Chir Scand 1968; 134: 481–7.Google Scholar
Dickenmann, M, Oetti, T, Mihatsch, MJ. Osmotic nephrosis: acute kidney injury with accumulation of proximal tubular lysosomes due to administration of exogenous solutes. Am J Kidney Dis 2008; 51: 491–503.Google Scholar
Solez, K. Pathogenesis of acute renal failure. Int Rev Exp Pathol 1983; 24: 277–328.Google ScholarPubMed
Levy, EM, Viscoli, CM, Horwitz, RI. The effect of acute renal failure on mortality. J Am Med Assoc 1996; 275: 1489–94.Google Scholar
Walker, RG, Dowling, JP, Alcorn, D, Ryan, GB, Kincaid-Smith, P. Renal pathology associated with lithium therapy. Pathology 1983; 15: 403–11.Google Scholar
Evans, M, Elinder, C-G. Chronic renal failure from lead: myth or evidence based fact. Kidney Int 2010; 79: 272–9.Google Scholar
Batuman, V, Wedeen, RP. The persistence of chronic lead nephropathy. Am J Kidney Dis 2014; 64: 1–3.Google Scholar
Walker, RG, Bennett, WM, Davies, BM, Kincaid-Smith, P. Structural and functional effects of long-term lithium therapy. Kidney Int 1982; 21(S11); S13–S19.Google Scholar
Markowitz, GS, Radhakrishnan, J, Kambham, N, et al. Litihium nephrotoxicity: a progressive combined glomerular and tubulointerstitial nephropathy. J Am Soc Nephrol 2000; 11: 1439–48.Google Scholar
Feingold, ML, Koss, LG. Effects of long-term administration of busulphan. Arch Int Med 1969; 124: 66–71.CrossRefGoogle Scholar
Airy, M, Raghavan, R, Truong, LD, Eknoyan, G. Tubulointerstitial nephritis and cancer chemotherapy: update on a neglected clinical entity. Nephrol Dial Transplant 2013; 28: 2502–9.Google Scholar
Daugas, E, Rougier, JP, Hill, G. HAART-related nephropathies in HIV infected patients. Kidney Int 2005; 67: 393–403.Google Scholar
Izzedine, H, Harris, M, Perazella, MA. The nephrotoxic effects of HAART. Nature Rev Nephrol 2009; 5: 563–73.Google Scholar
Mihatsch, MJ, Gudat, F, Zollinger, HU, Heierli, C, Reutter, FW. Systemic karyomegaly associated with chronic interstitial nephritis. A new disease entity? Clin Nephrol 1979; 12: 54–62.Google Scholar
Nadasdy, T, Laszik, Z, Blick, KE, Johnson, DL, Silva, FG. Tubular atrophy in the end-stage kidney. Hum Pathol 1994; 25: 22–8.Google Scholar
Hendricks, AR, Harris, AA, Walker, PD, Larsen, CP. Renal medullary angiitis: a case series from a single institution. Human Pathol 2013; 44: 521–1.CrossRefGoogle ScholarPubMed
Raghavan, R, Date, A, Bhaktaviziam, A. Fungal and nocardial infections of the kidney. Histopathology 1987; 11: 9–20.Google Scholar
Ramsay, AG, Olesnicky, L, Pirani, CL. Acute tubulointerstitial nephritis from Candida albicans with oliguric renal failure. Clin Nephrol 1985; 24: 310–4.Google Scholar
Kim, S, Kang, ET, Kim, YG, et al. Localization of Hantaan viral envelope glycoproteins by monoclonal antibodies in renal tissues from patients with Korean hemorrhagic fever H. Am J Clin Pathol 1993; 100: 398–403.Google Scholar
Farmer, ER, Heptinstall, RH. Chronic nonobstructive pyelonephritis – a reappraisal. In: Kincaid-Smith, P, Fairley, KF, eds. Renal infection and renal scarring. Melbourne: Mercedes Publishing; 1971, pp. 233–6.Google Scholar
Hodson, CJ, Wilson, S. Natural history of chronic pyelonephritis scarring. Br Med J 1965; 2: 191–4.Google Scholar
Parsons, MA, Harris, SC, Longstaff, AJ, Grainger, RG. Xanthogranulomatous pyelonephritis: a pathological, clinical and aetiological analysis of 87 cases. Diagn Histopathol 1983; 6: 203–19.Google Scholar
Grainger, RG, Longstaff, AJ, Parsons, MA. Xanthogranulomatous pyelonephritis: a reappraisal. Lancet 1982; 1:1398–401.Google Scholar
Khalyl-Mawad, J, Greco, A, Schinella, RA. Ultrastructural demonstration of intracellular bacteria in xanthogranulomatous pyelonephritis. Hum Pathol 1982; 13: 41–7.Google Scholar
Cadnapaphornchai, P, Rosenberg, BF, Taher, S, Prosnitz, EH, McDonald, FD. Bilateral renal parenchymal malakoplakia. New Engl J Med 1978; 299: 1110–13.Google Scholar
Dobyan, DC, Truong, LD, Eknoyan, G. Renal malakoplakia reappraised. Am J Kid Dis 1993; 22: 243–52.Google Scholar
Tam, VKK, Kung, WH, Li, R, Chan, KW. Renal parenchymal malakoplakia: a rare cause of ARF with a review of the literature. Am J Kidney Dis 2003; 41: E21.Google Scholar
Pettersson, E, Bonsdorff, M, Tornroth, T, Lindholm, H. Nephritis among young Finnish men. Clin Nephrol 1984; 22: 217–22.Google Scholar
Alpers, CE. The evolving contribution of renal pathology to understanding interstitial nephritis. Renal Failure 1998; 20: 763–71.Google Scholar
Laberke, HG, Bohle, A. Acute interstititial nephritis: correlations between clinical and morphological findings. Clin Nephrol 1980; 14; 263–73.Google Scholar
Baker, RJ, Pusey, CD. The changing profile of acute tubulointerstitial nephritis. Nephrol Dial Transplant 2004; 19: 8–11.Google Scholar
Perazella, M, Markowitz, GS. Drug-induced acute interstitial nephritis. Nat Rev Nephrol 2010; 6: 461–70.Google Scholar
Muriithi, AK, Leung, N, Valeri, AM, et al. Biopsy-proven acute interstitial nephritis, 1993–2011: a case series. Am J Kid Dis 2014; 64: 558–66.Google Scholar
D’Agati, VD, Theise, ND, Pirani, CL, Knowles, DM, Appel, GB. Interstitial nephritis related to nonsteroidal antiinflammatory agents and beta-lactam antibiotics: a comparative study of the interstitial infiltrates using monoclonal antibodies. Mod Pathol 1989; 2(4): 390–6.Google Scholar
Boucher, A, Droz, D, Adafer, E, Noël, LH. Characterization of mononuclear cell subsets in renal cellular interstitial infiltrates. Kidney Int 1986; 29: 1043–9.Google Scholar
Baldwin, DS, Levine, BB, McCluskey, RT, Gallo, GR. Renal failure and interstitial nephritis due to penicillin and methicillin. New Engl J Med 1968; 279: 1245–52.Google Scholar
Galpin, JE, Shinaberger, JH, Stanley, TM, et al. Acute interstitial nephritis due to methicillin. Am J Med 1978; 65: 756–65.Google Scholar
Dobrin, RS, Vernier, RL, Fish, AL. Acute eosinophilic interstitial nephritis with bone marrow-lymph node granulomas and anterior uveitis. Am J Med 1975; 59: 325–33.Google Scholar
Kobayashi, Y, Honda, M, Yoshikawa, N, Ito, H. Acute tubulointerstitial nephritis in 21 Japanese children. Clin Nephrol 2000; 54: 191–7.Google Scholar
Ellis, D, Fried, WA, Yunis, EJ, Blau, EB. Acute interstitial nephritis in children: a report of 13 cases and a review of the literature. Pediatrics 1981; 67: 861–70.Google Scholar
Cheng, H-F, Nolasco, F, Cameron, JS, et al. HLA DR display by renal tubular epithelium and phenotype of infiltrate in interstitial nephritis. Nephrol Dial Transplant 1989; 4: 205–15.Google Scholar
Rossert, J. Drug-induced acute interstitial nephritis. Kidney Int 2001; 60: 804–17.Google Scholar
Schwarz, A, Krause, PH, Kunzendorf, U, Keller, F, Distler, A. The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis. Clin Nephrol 2000; 54: 179–90.Google Scholar
Ferluga, D, Hvala, A, Vizjak, A, Trnacevic, S, Halilbasic, A. Renal function, protein excretion, and pathology of Balkan endemic nephropathy. III. Light and electron microscopic studies. Kidney Int (Suppl) 1991; 34: S57–67.Google Scholar
Podzik, AA, Berton, A, Schmeiser, HH, et al. Aristolochic acid nephropathy revisited: a place for innate and adaptive immunity? Histopathology 2010; 56: 449–63.Google Scholar
Brunner, FP, Selwood, NH. End-stage renal failure due to analgesic nephropathy, its changing pattern and cardiovascular mortality. Nephrol Dial Transplant 1994; 9: 1371–6.Google Scholar
Mihatsch, MJ, Khanlari, B, Brunner, FP. Obituary to analgesic nephropathy – an autopsy study. Nephrol Dial Transplant 2006; 21: 3139–45.CrossRefGoogle ScholarPubMed
Becker, JL, Miller, F, Nuovo, GJ, et al. Epstein–Barr virus infection of proximal renal tubule cells: possible role in chronic interstitial nephritis. J Clin Invest 1999; 104: 1673–81.Google Scholar
Nortier, JL, Vanherweghem, JL. For patients taking herbal therapy – lessons from aristolochic acid nephropathy. Nephrol Dial Transplant 2007; 22: 1512–7.Google Scholar
Bhandari, S, Kalowski, S, Collet, P, et al. Karyomegalic nephropathy: an uncommon cause of progressive renal failure. Nephrol Dial Transplant 2002; 17: 1914–20.Google Scholar
Zhou, W, Otto, EA, Cluckey, A, et al. FAN1 mutations cause karyomegalic interstitial nephritis, linking chronic kidney failure to defective DNA damage repair. Nature Genetics 2012; 44: 910–7.Google Scholar
Cremer, W, Bock, KD. Symptoms and course of chronic hypokalemic nephropathy in man. Clin Nephrol 1977; 7: 112–9.Google Scholar
Potter, WZ, Trygstad, CW, Helmer, OM, Nance, WE, Judson, WE. Familial hypokalemia associated with renal interstitial fibrosis. Am J Med 1974; 57: 971–7.Google Scholar
Zsurka, G, Ormos, J, Ivyani, B, et al. Mitochondrial mutation as a probable causative factor in familial progressive tubulointerstitial nephritis. Human Genet 1997; 99: 484–7.Google Scholar
Rotig, A, Goutieres, F, Niaudet, P, et al. Deletion of mitochondrial DNA in patients with chronic tubulointerstitial nephritis. J Pediatr 1995; 126: 597–601.Google Scholar
Kobayashi, A, Goto, Y, Nagata, M, Yamaguchi, Y. Granular swollen epithelial cells: a histologic and diagnostic marker of mitochondrial nephropathy. Am J Surg Pathol 2010; 34: 262–70.Google Scholar
Nasr, SH, Lucia, JP, Galgano, SJ, Markowitz, GS, D’Agati, VD. Uromodulin storage disease. Kidney Int 2008; 73: 971–6.Google Scholar
Bleyer, AJ, Kmoch, S. Autosomal dominant tubulointerstitial kidney disease: of names and genes. Kidney Int 2014; 86: 459–61.Google Scholar
Tzen, C-Y, Tsai, J-D, Wu, T-Y, et al. Tubulointerstitial nephritis associated with a novel mitochondrial point mutation. Kidney Int 2001; 59: 846–54.Google Scholar
Viero, RM, Cavallo, T. Granulomatous interstitial nephritis. Hum Pathol 1995; 26: 1347–53.Google Scholar
Mignon, F, Mery, JPH, Mougenout, B, et al. Granulomatous interstitial nephritis. Adv Nephrol 1984; 13: 219–45.Google Scholar
Bijol, V, Mendez, GP, Nosé, V, Rennke, HG. Granulomatous interstitial nephritis: a clinicopathologic study of 46 cases from a single institution. Int J Surg Pathol 2006; 14: 57–63.Google Scholar
Joss, N, Morris, S, Young, B, Geddes, C. Granulomatous interstitial nephritis. Clin J Am Soc Nephrol 2007; 2: 222–30.Google Scholar
Magil, AB. Drug-induced acute interstitial nephritis with granulomas. Hum Pathol 1983; 13: 36–41.Google Scholar
Schwarz, A, Krause, PH, Keller, F, Offermann, G, Mihatsch, MJ. Granulomatous interstitial nephritis after antiinflammatory drugs. Am J Nephrol 1988; 8: 410–6.Google Scholar
Robson, MG, Banerjee, D, Hopster, D, Cairns, HS. Seven cases of granulomatous interstitial nephritis in the absence of extrarenal sarcoid. Nephrol Dial Transplant 2003; 18: 280–4.Google Scholar
Alvarez, S, McCabe, WR. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine (Baltimore) 1984; 63: 25–55.CrossRefGoogle ScholarPubMed
Medlar, EM. Cases of renal infection in pulmonary tuberculosis. Am J Pathol 1926; 2: 401–13.Google Scholar
Cinman, AC. Genitourinary tuberculosis. Urology 1982; 20: 353–8.Google Scholar
Christiansen, WI. Genitourinary tuberculosis: review of 102 cases. Medicine (Baltimore) 1974; 53: 377–90.Google Scholar
Berliner, AR, Fine, DM, Lucas, GM, et al. Observations on a cohort of HIV-infected patients undergoing native renal biopsy. Am J Nephrol 2008; 28: 478–86.Google Scholar
Zaidan, M, Lescure, F-X, Brocheriou, I, et al. Tubulointerstitial nephropathies in HIV-infected patients over the past 15 years: a clinicopathological study. Clin J Am Soc Nephrol 2013; 8: 930–8.Google Scholar
French, MA. Immune reconstitution inflammatory syndrome: a reappraisal. Clin Infect Dis 2009; 48: 101–7.Google Scholar
Basu, D, illiams, FM, Ahn, CW, Reveille, JD. Changing spectrum of the diffuse infiltrative lymphocytosis syndrome. Arth Rheum 2006; 55: 466–72.Google ScholarPubMed
Zafrani, L, Coppo, P, Dettwiler, S, et al. Nephropathy associated with the diffuse infiltrative lymphocytosis syndrome. Kidney Int 2007; 72: 219–24.Google Scholar
Yoo, J, Baumstein, D, Kuppachi, S, Singh, A, Chander, PN. Diffuse infiltrative lymphocytosis syndrome presenting as reversible acute kidney injury associated with Gram-negative bacterial infection in patients with newly diagnosed HIV infection. Am J Kidney Dis 2011; 57: 752–5.Google Scholar
D’Agati, V, Suh, J-I, Carbone, L, Cheng, J-T, Appel, G. Pathology of HIV-associated nephropathy: a detailed morphologic and comparative study. Kidney Int 1989; 35: 1358–70.Google Scholar
Bourgoignie, JJ, Pardo, V. The nephropathology in human immunodeficiency (HIV-1) infection. Kidney Int 1991; 40: S19–23.Google Scholar
Rey, L, Viciana, A, Ruiz, P. Immunopathological characteristics of in situ T cell subpopulations in Human Immunodeficiency Virus-associated nephropathy. Hum Pathol 1995; 26: 408–15.Google Scholar
Tashima, KT, Horowitz, JD, Rosen, S. Indinavir nephropathy. New Engl J Med 1997; 336: 138–40.Google Scholar
Takeda, S, Haratake, J, Kasai, T, Takaeda, C, Takazakura, E. IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis. Nephrol Dial Transplant 2004; 19: 474–6.Google Scholar
Cornell, LD, Chicano, SL, Deshpande, V, et al. Pseudotumors due to IgG4 immune complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease. Am J Surg Pathol 2007; 31: 1586–97.CrossRefGoogle ScholarPubMed
Watson, SJW, Jenkins, DAS, Bellamy, COS. Nephropathy in IgG4-related systemic disease. Am J Surg Pathol 2006; 30: 1472–7.Google Scholar
Raissian, Y, Nasr, SH, Larsen, CP, et al. Diagnosis of IgG4-related tubulointerstitial nephritis. J Am Soc Nephrol 2011; 22: 1343–52.Google Scholar
Yamaguchi, Y, Kanetsuna, Y, Honda, K, et al. Characteristic tubulointerstitial nephritis in IgG4 related disease. Human Pathol 2012; 43: 536–49.Google Scholar
Kambham, N, Markowitz, GS, Tanji, N, et al. Idiopathic hypocomplementemic interstitial nephritis with extensive tubulointerstitial deposits. Am J Kidney Dis 2001; 37; 388–99.Google Scholar
Vaseemuddin, M, Schwartz, MM, Dunea, G, Kraus, MA. Idiopathic hypocomplementemic immune-complex-mediated tubulointerstitial nephritis. Nat Clin Pract Nephrol 2007; 3: 50–8.Google Scholar
Chang, A, Peutz-Kootstra, CJ, Kowaleska, J, et al. Giant cell tubulitis with tubular basement membrane immune deposits: a report of two cases after cardiac valve replacement surgery. Clin J Am Soc Nephrol 2006; 1: 920–4.Google Scholar
Hodgin, JB, Whelan, J, Markowitz, GS, Stokes, MB. Giant cell tubulitis with immune complex deposits in a patient with lupus nephritis. Am J Kidney Dis 2009; 53: 513–7.Google Scholar
Hever, A, Nast, CC. Polyoma virus nephropathy with simian virus 40 antigen-containing tubular basement membrane immune complex deposition. Hum Pathol 2008; 39: 73–9.Google Scholar
Andres, G, Brentjens, J, Kohli, R, et al. Histology of human tubulo-interstitial nephritis associated with antibodies to renal basement membranes. Kidney Int 1978; 13: 480–91.Google Scholar
Orfila, C, Rokotoavirony, J, Durand, D, Suc, JM. A correlative study of immunofluorescence, electron and light microscopy in immunologically mediated renal tubular disease in man. Nephron 1979; 23: 14–22.Google Scholar
Ivyani, B, Haszon, I, Endreffy, E, et al. Childhood membranous nephropathy, circulating antibodies to the 58-kD TIN antigen, and antitubular basement membrane nephritis: an 11-year follow-up. Am J Kidney Dis 1998; 32: 1068–74.Google Scholar
Markowitz, GS, Seigle, RL, D’Agati, VD. Three-year-old boy with partial Fanconi syndrome. Am J Kidney Dis 1999; 34: 184–8.Google Scholar
Levy, M, Guesry, P, Loirat, C, et al. Immunologically mediated tubulointerstitial nephritis in children. Contrib Nephrol 1979; 16: 132–40.Google Scholar
Houghton, DC, Troxell, ML. An abundance of IgG4+ plasma cells is not specific for IgG4-related tubulointerstitial nephritis. Modern Pathol 2011; 24: 1480–7.Google Scholar
Herlitz, LC, D’Agati, V, Markowitz, GS. Crystalline nephropathies. Arch Pathol Lab Med 2012; 136: 713–20.Google Scholar
Markowitz, GS, Stokes, MB, Radhakrishnan, J, D’Agati, VD. Acute phosphate nephropathy following oral sodium phosphate bowel purgative: an unrecognized cause of chronic renal failure. J Am Soc Nephrol 2005; 16: 3389–96.Google Scholar
Kim, Y-G, Kim, B, Kim, M-K, et al. Medullary nephrocalcinosis associated with long-term furosemide abuse in adults. Nephrol Dial Transplant 2001; 16: 2303–9.Google Scholar
Markowitz, GS, Perazella, MA. Drug-induced renal failure: a focus on tubulointerstitial disease. Clin Chim Acta 2005; 351: 31–47.Google Scholar
Perazella, MA. Crystal induced acute renal failure. Am J Med 1999; 106: 459–65.Google Scholar
Coe, FL, Evan, A, Worcester, E. Kidney stone disease. J Clin Invest 2005; 115: 2598–608.Google Scholar
Evan, AP, Coe, FL, Lingeman, JE, et al. Mechanism of formation of human calcium oxalate renal stones on Randall’s plaque. Anatomic Rec 2007; 290: 1315–23.Google Scholar
Coe, FL, Evan, AP, Lingeman, JE, Worcester, EM. Plaque and deposits in nine human stone diseases. Urol Res 2010; 38: 239–47.Google Scholar
Linnes, MP, Krambeck, AE, Cornell, L, et al. Phenotypic characterization of kidney stone formers by endoscopic and histological quantification of intrarenal calcification. Kidney Int 2013; 84: 818–25.Google Scholar
Wang, X, Krambeck, AE, Williams, JC, et al. Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of Randall’s plaque. Clin J Am Soc Nephrol 2014; 9: 1757–63.Google Scholar
Harrison, J, Inglis, JA, Tolley, DA. Percutaneous renal biopsy specimens in stone formers. J Clin Path 1988; 41: 971–4.Google Scholar

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