Chapter 526 Tubulointerstitial Nephritis
Acute Tubulointerstitial Nephritis
Pathogenesis and Pathology
The hallmarks of acute TIN are lymphocytic infiltration of the tubulointerstitium, tubular edema, and varying degrees of tubular damage. Eosinophils may be present, especially in drug-induced TIN; occasionally, granulomas occur. The pathogenesis is not fully understood, but a T cell–mediated immune mechanism has been postulated. A large number of medications, especially antimicrobials, anticonvulsants, and analgesics, have been implicated as etiologic agents (Table 526-1). Other causes include infections, primary glomerular diseases, and systemic diseases such as systemic lupus erythematosus (SLE).
