Acute tubulointerstitial nephritis following adenovirus and respiratory syncytial virus infection

被引:0
作者
de Suremain, A. [1 ]
Somrani, R. [1 ,2 ]
Bourdat-Michel, G. [2 ]
Pinel, N. [3 ,4 ]
Morel-Baccard, C. [3 ,4 ]
Payen, V. [1 ]
机构
[1] CHU Grenoble, Clin Univ Reanimat Pediat & Med Neonatale, F-38043 Grenoble 9, France
[2] CHU Grenoble, Clin Univ Nephrol Pediat, F-38043 Grenoble 9, France
[3] CHU Grenoble, Dept Virol, Inst Biol & Pathol, F-38043 Grenoble 9, France
[4] CHU Grenoble, Dept Anat & Cytol Pathol, F-38043 Grenoble 9, France
来源
ARCHIVES DE PEDIATRIE | 2015年 / 22卷 / 05期
关键词
ACUTE INTERSTITIAL NEPHRITIS;
D O I
10.1016/j.arcped.2015.02.012
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Acute tubulointerstitial nephritis (TIN) is responsible for nearly 10% of acute renal failure (ARF) cases in children. It is mostly drug-induced, but in a few cases viruses are involved, probably by an indirect mechanism. An immune-competent 13-month-old boy was admitted to the intensive care unit for severe ARF with anuria in a context of fever, cough, and rhinorrhea lasting 1 week. The kidney biopsy performed early brought out tubulointerstitial damage with mild infiltrate of lymphocytes, without any signs of necrosis. There were no virus inclusion bodies, no interstitial hemorrhage, and no glomerular or vascular damage. Other causes of TIN were excluded: there was no biological argument for an immunological, immune, or drug-induced cause. Adenovirus (ADV) and respiratory syncytial virus (RSV) were positive in respiratory multiplex polymerase chain reaction (PCR) in nasal aspirate but not in blood, urine, and renal tissue. The patient underwent dialysis for 10 days but the response to corticosteroid therapy was quickly observed within 48 h. The mechanism of TIN associated with virus infection is unknown. However, it may be immune-mediated to be able to link severe renal dysfunction and ADV and/or RSV invasion of the respiratory tract. (C) 2015 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:528 / 532
页数:5
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