Classification of Tubulointerstitial Diseases



Classification of Tubulointerstitial Diseases


Robert B. Colvin, MD








Acute interstitial nephritis was originally described in 1898 by William Councilman as a systemic response to certain extrarenal infections (here an untreated streptococcal infection).






Tubulitis, invasion of tubules by lymphocytes image, is a common finding in immunologically mediated tubulointerstitial disease, as illustrated in this example associated with uveitis (TINU syndrome).


TERMINOLOGY


Abbreviations



  • Acute interstitial nephritis (AIN)


  • Chronic interstitial nephritis (CIN)


  • Acute tubular necrosis (ATN)


  • Acute tubular injury (ATI)


Synonyms



  • Tubulointerstitial nephritis


  • Interstitial nephritis


Definitions



  • Group of diseases primarily manifested by inflammation &/or injury of renal tubules and interstitium


ETIOLOGY/PATHOGENESIS


Genetic



  • Storage diseases, crystal deposition, transport abnormalities, mitochondrionopathies


Infection



  • Direct infection of kidney by bacteria, viruses, fungi, protozoa, rickettsia


  • Indirect effects of systemic infection



    • C. diphtheriae, Streptococcus, and many other organisms


Toxic



  • Heavy metals, biologic toxins, organic compounds


Metabolic



  • Monoclonal protein deposition, milk alkali syndrome, hypokalemia


Immunologic



  • Autoimmune, drug allergy, allograft rejection


Ischemia



  • Shock


  • Hypovolemia

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Classification of Tubulointerstitial Diseases
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