Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis
Acute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can b...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-11-01
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| Series: | Kidney Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S259005952030217X |
| _version_ | 1819073779176833024 |
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| author | Benjamin A. Schwartz Jason M. Kidd |
| author_facet | Benjamin A. Schwartz Jason M. Kidd |
| author_sort | Benjamin A. Schwartz |
| collection | DOAJ |
| description | Acute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can be clinically observed as glycosuria, eosinophilia, leukocytes or white blood cell casts, and proteinuria. We present a case of an otherwise healthy woman in her 30s with AIN presenting with acute kidney injury and glycosuria without pyuria. This patient had an atypical presentation of AIN that lacked classic diagnostic laboratory features and has been rarely reported. She had profound glycosuria in the setting of normoglycemia, which resolved following a course of corticosteroids. Glycosuria was most likely due to proximal tubule damage from AIN. This case supports previous hypotheses that drug-induced AIN can cause proximal tubule dysfunction resulting in glycosuria in the absence of other identifiable proximal tubule dysregulations. We hypothesize that resolution of AIN involves the repair and restoration of sodium-dependent glucose cotransporter function. |
| first_indexed | 2024-12-21T17:59:02Z |
| format | Article |
| id | doaj.art-2cde9768051e4429be9619d34862f0ff |
| institution | Directory Open Access Journal |
| issn | 2590-0595 |
| language | English |
| last_indexed | 2024-12-21T17:59:02Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj.art-2cde9768051e4429be9619d34862f0ff2022-12-21T18:55:07ZengElsevierKidney Medicine2590-05952020-11-0126801803Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial NephritisBenjamin A. Schwartz0Jason M. Kidd1Division of Nephrology, Virginia Commonwealth University, Richmond, VAAddress for Correspondence: Jason M. Kidd, MD, Department of Internal Medicine, Division of Nephrology, 1101 E Marshall St, PO Box 980160, Richmond, VA 23298.; Division of Nephrology, Virginia Commonwealth University, Richmond, VAAcute interstitial nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging because these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation, which can be clinically observed as glycosuria, eosinophilia, leukocytes or white blood cell casts, and proteinuria. We present a case of an otherwise healthy woman in her 30s with AIN presenting with acute kidney injury and glycosuria without pyuria. This patient had an atypical presentation of AIN that lacked classic diagnostic laboratory features and has been rarely reported. She had profound glycosuria in the setting of normoglycemia, which resolved following a course of corticosteroids. Glycosuria was most likely due to proximal tubule damage from AIN. This case supports previous hypotheses that drug-induced AIN can cause proximal tubule dysfunction resulting in glycosuria in the absence of other identifiable proximal tubule dysregulations. We hypothesize that resolution of AIN involves the repair and restoration of sodium-dependent glucose cotransporter function.http://www.sciencedirect.com/science/article/pii/S259005952030217XAcute interstitial nephritisacute kidney injurydrug induced interstitial nephritisglycosuria |
| spellingShingle | Benjamin A. Schwartz Jason M. Kidd Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis Kidney Medicine Acute interstitial nephritis acute kidney injury drug induced interstitial nephritis glycosuria |
| title | Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis |
| title_full | Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis |
| title_fullStr | Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis |
| title_full_unstemmed | Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis |
| title_short | Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis |
| title_sort | glycosuria and acute kidney injury a rare presentation of acute interstitial nephritis |
| topic | Acute interstitial nephritis acute kidney injury drug induced interstitial nephritis glycosuria |
| url | http://www.sciencedirect.com/science/article/pii/S259005952030217X |
| work_keys_str_mv | AT benjaminaschwartz glycosuriaandacutekidneyinjuryararepresentationofacuteinterstitialnephritis AT jasonmkidd glycosuriaandacutekidneyinjuryararepresentationofacuteinterstitialnephritis |