Case Report
Acute Tubulointerstitial Nephritis
Following Intravenous Immunoglobulin Therapy in a Male Infant with
Minimal-Change Nephrotic Syndrome
- HIROSHI TANAKA,
SHINOBU WAGA, TAKASHI
TATEYAMA, KAZUHIKO
SUGIMOTO, YOSHIKI
KAKIZAKI and MASARU
YOKOYAMA
- Department of Pediatrics, Hirosaki
University School of Medicine, Hirosaki 036-8562
A boy aged 4 years with
nephrotic syndrome (NS) was referred to our hospital because of the
third relapse of NS. Hypogammaglobulinemia associated with massive
proteinuria was observed at the presentation. Residual urinary tract
infection required intravenous piperacillin and immunoglobulin
therapy (IVIG). Soon after IVIG, he complained of high fever with
chills, bilateral knee joint pain, dry cough and chest discomfort.
Although he did not develop renal insufficiency, a transient increase
in the urinary b2-microglobulin and decrease in
the serum complement hemolytic activity were observed. These clinical
manifestations spontaneously ceased. A percutaneous renal biopsy for
his NS performed 19 days after the episode of allergic rection
revealed tubulointerstitial nephritis (TIN) with marked eosinophil
infiltrates. Glomeruli showed minor glomerular abnormalities. Renal
complications associated with IVIG treatment have been reported to
date, however, acute TIN has rarely been seen.
Key words--- acute tubulointerstitial
nephritis; hypersensitivity reaction; intravenous immunoglobulin
therapy; minimal-change nephrotic syndrome
© 1999 Tohoku University Medical Press
Tohoku J. Exp. Med., 1999,
189,155-161
Address for reprints: Hiroshi Tanaka, M.D., Department of
Pediatrics, Hirosaki University School of Medicine, 5 Zaifu-cho,
Hirosaki 036-8562, Japan.
e-mail: hirotana@cc.hirosaki-u.ac.jp
Back to CONTENTS.