Predominant tubulointerstitial lupus nephritis

• Published in: American journal of kidney diseases Vol. 27; no. 2; p. 273
• Main Authors: Singh, A K, Ucci, A, Madias, N E
• Format: Journal Article
• Language: English
• Published: United States 01-02-1996
• Subjects: Acute Kidney Injury - etiology; Glucocorticoids - therapeutic use; Humans; Kidney Glomerulus - immunology; Kidney Glomerulus - pathology; Kidney Tubules - immunology; Kidney Tubules - pathology; Lupus Nephritis - complications; Lupus Nephritis - drug therapy; Lupus Nephritis - epidemiology; Lupus Nephritis - pathology; Male; Middle Aged; Nephritis, Interstitial - epidemiology; Nephritis, Interstitial - pathology; Prednisone - therapeutic use
• ISSN: 0272-6386
• DOI: 10.1016/S0272-6386(96)90553-3

Predominant tubulointerstitial lupus nephritis is rare. Only eight cases have been described in the literature. We report the case of a 59-year-old man with systemic lupus erythematosus who presented with acute renal failure. On renal biopsy, he was found to have chronic tubulointerstitial nephritis with a mononuclear infiltrate. The immunofluorescence showed immune deposits in the tubular basement membranes, interstitium, and glomerular capsule. The glomeruli were minimally involved. He was initially treated with high-dose corticosteroids and supported with hemodialysis. Renal function improved and dialysis was discontinued after three treatments. The corticosteroid dosage was gradually tapered. Renal function after 72 months of follow-up has remained stable (serum creatinine, approximately 1.9 mg/dL) and except for one relapse, there has been no clinical or serologic evidence of lupus activity. Furthermore, 24-hour urinary protein excretion has remained within the normal range.