尿細管間質性病変を呈した腎生検例の検討 : 1990年から2002年までの53例について

概要

論文の詳細を見る
Between 1990 and 2002, 1998 renal biopsies were performed of which 53 cases (55 renal biopsies,male 34, female 19, age 0-75 years old) had primary tubulointerstitial lesions. Clinically, 39 cases with primary tubulointerstitial lesions had acute renal failure (39/53＝73%)and such lesions were the second most frequent cause of acute renal failure among all the renal biopsies. Histopathologically, the tubulointerstitial lesions included tubulointerstitial nephritis (32 cases), tubular necrosis (9), interstitial fibrosis (6), and other lesions (6). The causes of tubulointerstitial nephritis were infectious (6 cases), drug induced (3), collagen disease (4), contrast media (1), tumor (1)and unknown (17). It is not possible to determine the cause of tubulointerstitial nephritis histopathologically as none of the histopathological changes are pathognomonic. Tubular necrosis was induced by dehydration, mushroom　pisoning, boric acid ingestion and alcohol consumption. The fibrosis cases included progressive systemic sclerosis, Chinese herb nephropathy and Fanconi syndrome. Chinese herb nephropathy was found in 2 cases with marked interstitial fibrosis. In conclusion, tubulointerstitial nephritis and other tubulointerstitial lesions accounted for a rather high percentage of cases of acute renal failure. Renal biopsy is a useful tool for the differential diagnosis of acute renal failure such as tubulointerstitial nephritis.
信州医学会の論文