Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohsen Basiri M.D.
Overview
Common causes of interstitial nephritis include drug side effects, particularly analgesics and antibiotics. Other common causes include associated nephrologic conditions, as well as microbial infections.
Causes
Drugs (with antibiotics responsible for 30 to 49 percent of these cases) – 70
to 75 percent
Any drug has potentiality to cause AIN, among case reports of many drugs causing AIN, but only a few have been reported with biopsy-proven AIN. The most common proven drugs cause of AIN include:
- Nonsteroidal anti-inflammatory agents (NSAIDs)
- Penicillins and cephalosporins
- Antimicrobial sulfonamides, including trimethoprim-sulfamethoxazole
- Rifampin
- Diuretics, including loop diuretics such as furosemide and bumetanide, and
- thiazide-type diuretics
- Ciprooxacin and, perhaps to a lesser degree, ● other quinolones
- Cimetidine
- Allopurinol
- Proton pump inhibitors such as omeprazole and lansoprazole
- Indinavir
- 5-aminosalicylates (eg, mesalamine)
Infections
bacterial infection (must be accompanied by obstruction or reflux),Multiple organisms have been associated with AIN including:
A histologic variant of AIN that is characterized by granuloma formation has been associated with Mycobacterium, fungi (histoplasmosis, coccidiomycosis), bacteria (Brucella, Chlamydia), spirochetes (Francisella, Treponema), and parasites
(Leishmania, Toxoplasma) [30]. (See 'Histology' below.)
Initial reports suggested that organisms such as Legionella, Leptospira, CMV, and Streptococcus primarily invaded organs remote from the kidney and exerted an inammatory response in the kidney without invading the kidney [28,29].
However, more recent reports describe the identication of organism-specic antigens or DNA in kidney proximal tubule cells of patients with AIN [27,31-33].
Legionella,
Leptospira,
cytomegalovirus (CMV)
Streptococcus,
Mycobacterium tuberculosis,
Corynebacterium diphtheriae,
Epstein-Barr virus (EBV),
Yersinia,
polyomavirus,
Enterococcus,
Escherichia coli,
adenovirus,
Candida, and others
| Cardiovascular
|
Granulomatosis with polyangiitis, Kawasaki's disease
|
| Chemical/Poisoning
|
Aristolochia, Quinine, Thiazide diuretics
|
| Dental
|
No underlying causes
|
| Dermatologic
|
Rubeola infection,
|
| Drug Side Effect
|
Acetaminophen , Acyclovir, Aldomet, Allopurinol, Alpha-interferon, Amlodipine, Ampicillin, Anitrim, Anti-tubular basement membrane antibodies , Apo-sulfatrim, Aspirin, Azathioprine, Bactelan, Batrizol, Bumetanide, Captopril, Carbamazepine, Cefaclor, Cefotaxime sodium, Cefoxitin sodium, Cephalosporin, Chlorthalidone, Cimetidine , Ciprofloxacin, Clofibrate, Cox-2 inhibitors, Creatine, Dabrafenib mesylate, Diazepam, Diclofenac, Diflunisal, Diltiazem, Diphenylhydantoin, Diuretics, Doxycycline, Ectaprim, Enterobacticel, Erythromycin, Esteprim, Ethambutol, Famotidine, Fenoprofen, Flurbiprofen, Furosemide, Griseofulvin, Hydralazine, Hydrochlorothiazide, Ibuprofen, Indinavir, Indomethacin, Isobac, Isoniazid, Kelfiprim, Ketoprofen, Lansoprazole, Macrolides, Mesalamine, Mesalazine, Methicillin, Metoxiprim, Minocycline hydrochloride, Naproxen, Novo-trimel, Nu-cotrimox, Olsalazine, Omeprazole, Oxacillin, Oxaprozin, Oxytetracycline, Pegylated interferon alfa-2b, Penicillin , Phenindione, Phenobarbital, Phenteramine, Phenylpropanolamine, Phenytoin, Piperacillin/tazobactam, Piroxicam, Polymyxin, Pranlukast, Propylthioruacil, Pro-trin, Rabeprazole, Ranitidine, Rifampin, Roubac, Streptomycin, Sulfatrim ds, Sulfinpyrazone, Sulfonamide, Sulfoxaprim, Sulindac, Syraprim, Tenofovir disoproxil fumarate, Tetracycline, Thiazide diuretics, Tolmetin, Treponema, Triamterene, Trimesuxol, Trimethoprim-sulfamethoxazole, Trimetoger, Trimetox, Trimzol, Trisulfa, Trisulfam, Uroplus ds, Uroplus ss, Vancomycin
|
| Ear Nose Throat
|
Sjogren syndrome
|
| Endocrine
|
No underlying causes
|
| Environmental
|
No underlying causes
|
| Gastroenterologic
|
Escherichia coli, Inflammatory bowel disease
|
| Genetic
|
Alport syndrome, Bardet-biedl syndrome
|
| Hematologic
|
Hypercalcemia, Hyperkalaemic distal renal tubular acidosis, Hyperuricemia, Hypokalemia, Sickle cell disease
|
| Iatrogenic
|
No underlying causes
|
| Infectious Disease
|
Adenovirus, Brucella, Candida, Chlamydia, Coccidioidomycosis, Corynebacterium diphtheriae, Cytomegalovirus, Diphtheria, Enterococcus, Epstein-barr virus , Escherichia coli, Francisella, Hantaan virus, Histoplasmosis, Hiv infection, Legionellosis, Leishmaniasis, Leptospirosis, Mycobacterium tuberculosis, Mycoplasma infection, Polyomavirus, Rickettsia infection, Rubeola infection, Streptococcal infection, Syphilis, Toxoplasmosis, Uveitis, Yersinia
|
| Musculoskeletal/Orthopedic
|
No underlying causes
|
| Neurologic
|
No underlying causes
|
| Nutritional/Metabolic
|
Creatine, Hyperuricemia, Hypokalemia
|
| Obstetric/Gynecologic
|
No underlying causes
|
| Oncologic
|
Myeloma
|
| Ophthalmologic
|
Uveitis
|
| Overdose/Toxicity
|
Cocaine
|
| Psychiatric
|
No underlying causes
|
| Pulmonary
|
Hantaan virus, Histoplasmosis, Sarcoidosis
|
| Renal/Electrolyte
|
Alport syndrome, Granulomatosis with polyangiitis, Hyperkalaemic distal renal tubular acidosis, Reflux nephropathy, Renal failure, Sensenbrenner syndrome, Tubulointerstitial nephritis, Wegener's granulomatosis
|
| Rheumatology/Immunology/Allergy
|
Igg4-related disease, Kawasaki's disease, Sarcoidosis, Sicca syndrome, Systemic lupus erythematosus
|
| Sexual
|
Hiv infection, Syphilis
|
| Trauma
|
No underlying causes
|
| Urologic
|
No underlying causes
|
| Miscellaneous
|
No underlying causes
|
Causes in Alphabetical Order
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References
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