Interstitial nephritis historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief:Mohsen Basiri M.D.
Overview
In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; In autopsy kidneys of children dying of diphtheria and scarlet fever.He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.
Historical Perspective
In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; in autopsy kidneys of children dying of diphtheria and scarlet fever.[1] He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.
With development of renal biopsy led to find of similar characteristic in association with drug-related renal failure, histological examination in acute TIN reveals an infiltrate, which is largely composed of T cells, together with some macrophages and plasma cells. As there is some evidence for cutaneous delayed-type hypersensitivity and positive in vitrolymphocyte stimulation tests in response to suspected drugs, the etiology is presumed to be immune-mediated [2]. This is illustrated by the rapid recrudescence of disease upon inadvertent rechallenge in drug-related ATIN, a clear manifestation of an immunological memory response.[3][4]
References
- ↑ Councilman WT. Acute interstitial nephritis. J Exp Med 1898; 3: 393
- ↑ Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722
- ↑ Pusey CD, Saltissi D, Bloodworth L, Rainford DJ, Christie JL. Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy. Q J Med 1983; 52: 194–211
- ↑ Sloth K, Thomsen AC. Acute renal insufficiency during treatment with azathioprine. Acta Med Scand 1971; 189: 145–148