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'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] <nowiki></nowiki>; '''Associate Editor(s)-in-Chief:'''{{M.B}}
 
== Overview ==
In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; In autopsy kidneys of children dying of [[diphtheria]] and [[scarlet fever]].He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.
 
== Historical Perspective ==
In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; in autopsy kidneys of children dying of [[diphtheria]] and [[scarlet fever]].<ref name=":0">Councilman WT. Acute interstitial nephritis. J Exp Med 1898; 3: 393</ref> He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of [[Antibiotic|antibiotics]].
 
With development of renal biopsy led to find of similar characteristic in association with drug-related renal failure, histological examination in acute TIN reveals an infiltrate, which is largely composed of T cells, together with some macrophages and plasma cells. As there is some evidence for cutaneous delayed-type hypersensitivity and positive ''in vitro''lymphocyte stimulation tests in response to suspected drugs, the etiology is presumed to be immune-mediated <ref>Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722</ref>. This is illustrated by the rapid recrudescence of disease upon inadvertent rechallenge in drug-related ATIN, a clear manifestation of an immunological memory response.<ref>Pusey CD, Saltissi D, Bloodworth L, Rainford DJ, Christie JL. Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy. Q J Med  1983; 52: 194–211</ref><ref>Sloth K, Thomsen AC. Acute renal insufficiency during treatment with azathioprine. Acta Med Scand  1971; 189: 145–148</ref>
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 23:25, 31 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief:Mohsen Basiri M.D.

Overview

In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; In autopsy kidneys of children dying of diphtheria and scarlet fever.He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.

Historical Perspective

In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; in autopsy kidneys of children dying of diphtheria and scarlet fever.[1] He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.

With development of renal biopsy led to find of similar characteristic in association with drug-related renal failure, histological examination in acute TIN reveals an infiltrate, which is largely composed of T cells, together with some macrophages and plasma cells. As there is some evidence for cutaneous delayed-type hypersensitivity and positive in vitrolymphocyte stimulation tests in response to suspected drugs, the etiology is presumed to be immune-mediated [2]. This is illustrated by the rapid recrudescence of disease upon inadvertent rechallenge in drug-related ATIN, a clear manifestation of an immunological memory response.[3][4]

References

  1. Councilman WT. Acute interstitial nephritis. J Exp Med 1898; 3: 393
  2. Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722
  3. Pusey CD, Saltissi D, Bloodworth L, Rainford DJ, Christie JL. Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy. Q J Med 1983; 52: 194–211
  4. Sloth K, Thomsen AC. Acute renal insufficiency during treatment with azathioprine. Acta Med Scand 1971; 189: 145–148

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