Internal Medicine

(Wang) #1

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22


1466 Tubulointerstitial Renal Disease
Viral – EBV, CMV, HIV, rubella, polyoma, Hanta, HSV, Hepa-
titis B
Parasites – Leishmania, Toxoplasma
Fungal – Histoplasmosis
Rickettsia
➣Idiopathic
TINU – anterior uveitis and acute TIN
diagnosed after exclusion of infection, drug or systemic disease
■Chronic Tubulointerstitial Nephritis (CTIN)
➣common causes:
immune disease
drugs
infection
obstruction and reflux
hematopoietic disease
heavy metals
metabolic disease
hereditary disease
granulomatous disease
others
idiopathic
➣Immune disease
Lupus nephritis
Mixed cryoglobulinemia
Goodpasture’s syndrome
Chronic rejection of renal transplant
Amyloidosis
Sjogren’s disease
➣Drugs
prolonged and excessive exposure
analgesics / NSAIDS
Lithium
Cis-platinum
Nitrosoureas
Cyclosporine / FK 506
Chinese herbs
➣Infections
increased risk with concurrent UTI and obstruction or vesi-
coureteral reflux
➣Obstruction and Reflux
obstruction and vesicoureteral reflux can result in tubuloint-
erstitial damage even without infection
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