ArticleBMC nephrology2025
Acute tubulointerstitial nephritis (ATIN) including drug-induced, tubulointerstitial nephritis and uveitis (TINU), ANCA-associated vasculitis (AAV), kidney- limited sarcoidosis, and hemolysis: a case series from Syria.
Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Acute renal injury in ANCA-associated glomerulonephritis: etiology related to acute tubulointerstitial injury versus glomerular injury.Renal failure · 2026Article
- Proteinuria in adolescence.Pediatric nephrology (Berlin, Germany) · 2026Review
- Tubulointerstitial nephritis and uveitis syndrome in a patient with diabetic nephropathy: a case report and literature review.Frontiers in medicine · 2026Article
- Association Between Dipeptidyl Peptidase-4 Inhibitor Use and Acute Kidney Injury in Patients With Diabetes Mellitus: A Disproportionality Analysis Based on the FAERS.In vivo (Athens, Greece)Article
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Abstract
backgroundThis study aimed to detail acute tubulointerstitial nephritis (ATIN) patients, from relevant clinical manifestations to outcomes.
methodsWe reviewed ATIN patients between 2018 and 2022. All demographic data, labs, biopsy findings, treatment protocols, and outcomes were reported.
resultsATIN was diagnosed in nine patients, eight by kidney biopsy and one clinically. Drug-induced ATIN (DI-ATIN) was reported in five patients, including rifampin (RIF), allopurinol, mesalamine, and two with cephalosporins. Severe ATIN resulted after the first dose of RIF aligned with liver injury, hemolysis, and thrombocytopenia. Also, mesalamine and allopurinol induced gradual kidney failure a few months after the drug initiation. A patient with Tubulointerstitial nephritis and uveitis (TINU) syndrome showed refractory uveitis presenting during glucocorticoids (GCs) tapering, which resolved quickly with azathioprine (AZA) when not responding to GCs reescalation. Among the rarest cases, ATIN induced by a kidney-limited sarcoidosis, G6PD patient with hemolysis induced ATIN, and isolated ATIN induced by ANCA-associated vasculitis (AAV) with positive C-ANCA, which the latter representing the first case in our country and the fourth case worldwide. Labs showed anemia (88.8%), ESR elevation (85.7%), microscopic hematuria (in all patients), pyuria (44.4%), and proteinuria (77.7%). Biopsies showed interstitial infiltrations mainly with lymphocytes and monocytes. Eosinophils were found in one biopsy and neutrophils showed in 4 biopsies (50%).
conclusionATIN is a disease with a diagnostic challenge, thus clinicians should maintain a high suspicion for diagnosis. The combination of AKI with positive tests (especially abnormal urine sediment, ESR elevation, and anemia) may suggest ATIN diagnosis and further support the treatment initiation, particularly when kidney biopsy is unable to be performed or when the inciting agent is predictable.
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