Disease Information for Nephritis, analgesic, interstitial

Clinical Manifestations
Signs & Symptoms
High blood pressure/sign
Excess Thirst in Elderly
Excessive thirst/polydipsia
Dry mouth/Mucous membranes
Muscle weakness
Headache/chronic recurrent
Nocturia in Elderly
Acutely ill patient/signs
Thirst Increased
Clinical Presentation & Variations
AIDS with Renal failure
Disease Progression
Course/Chronic disorder
Course/Chronic only
Demographics & Risk Factors
Established Disease Population
Patient/On Medications long term/ usually
Patient/Peptic ulcer disease
Patient/Depression, chronic
Laboratory Tests
Microbiology & Serology Findings
Microlab/Sterile urine
Abnormal Lab Findings (Non Measured)
URINE Isosthenuria/mid-range SPGR
Renal function abnormalities (Lab)
URINE Dipstick /Blood abnormal
URINE Dipstick/Leukocytes Positive
URINE Pyuria
URINE Pyuria with negative cultures
URINE Sediment/Urinalysis abnormal
URINE Specific gravity fixed/1.010
Abnormal Lab Findings - Decreased
BUN/Creatinine ratio (Lab)
Creatine clearance (Lab)
URINE Specific gravity
Abnormal Lab Findings - Increased
BUN/Blood urea nitrogen (Lab)
Creatinine, serum (Lab)
Fractional excretion Sodium (Lab)
Potassium, serum (Lab)
URINE Casts/Protein casts
URINE Eosinophiles
URINE Epithelial/round cells
URINE Leukocyte casts
URINE Leukocytes
URINE Protein (Albumin)
URINE Red blood cells
URINE Sodium
Diagnostic Test Results
BX/Renal Abnormal
BX/Renal Cortex tubulointerstitial nephritis/acute
CT Scan
CT Scan/Renal (Kidney) Abnormal
CT Scan/Renal without contrast/Abnormal
CT Scan/Renal/Bumpy contours indentations cortex
CT Scan/Renal/No contrast/Papillary calcifications.
CT Scan/Renal/No contrast/Small kidneys
X-RAY With contrast
IVP/Decreased dye visualization/bilateral
IVP/Papillary destruction/amputation
Ultrasound/Renal/Kidneys echogenic cortex bilateral
Associated Diseases & Rule outs
Associated Disease & Complications
Acute Tubulointerstitial Nephropathy
Drug induced Nephritis/Nephropathy
Hypertensive heart disease
Isosthenuria syndrome
Kidney stone/Nephrolithiasis/Urolithiasis
Nephritis tubulointerstitial
Nephritis, analgesic/interstitial
Nephritis, interstitial
Nephritis, non-allergic interstitial
Nephritis, secondary
Nephrogenic diabetes insipidus
Peptic ulcer disease
Pyelonephritis, acute
Renal colic
Renal Failure Chronic
Renal papillary necrosis
Renal tubular acidosis, distal
Renal tubule acidosis, acquired
Toxic nephritis/Chronic persistent
Toxic Nephritis/Nephropathy
Ureter obstruction
Proteinuria in Elderly
Disease Mechanism & Classification
CLASS/Renal/kidney involvement/disorder (ex)
CLASS/Urologic (category)
Pathophysiology/Defective Potassium excretion/renal
Pathophysiology/Renal concentration capacity defect
PROCESS/Drug induced disorder (ex)
PROCESS/Medication/Drug (CONFIRM dose/before treatment)
PROCESS/Poisoned organ/system (category)
Analgesic nephropathy, Analgesic nephropathy (disorder), drug nephropathy analgesic, NEPHROPATHY ANALGESIC, Synonym/Acute tubulointerstitial nephritis syndrome, Synonym/Analgesic nephropathy
Drug Therapy - Indication
SX/Renal biopsy

Diagnosis: Fever; Transient maculopapular rash; Acute renal insufficiency; Pyuria (including eosinophiluria), white blood cell casts, and hematuria; Acute interstitial nephritis accounts for 10-15% of cases of intrinsic renal failure; An interstitial inflammatory response with edema and possible tubular cell damage is the typical pathologic finding; Cell-mediated immune reactions prevail over humoral responses; T lymphocytes can cause direct cytotoxicity or release lymphokines that recruit monocytes and inflammatory cells; Although drugs account for over 70% of cases, acute interstitial nephritis also occurs in infectious diseases, immunologic disorders, or as an idiopathic condition; The most common drugs are penicillins and cephalosporins, sulfonamides and sulfonamide-containing diuretics, NSAIDs, rifampin, phenytoin, and allopurinol; Infectious causes include streptococcal infections, leptospirosis, cytomegalovirus, histoplasmosis, and Rocky Mountain spotted fever; Immunologic entities are more commonly associated with glomerulonephritis, but systemic lupus erythematosus, Sjögren"s syndrome, sarcoidosis, and cryoglobulinemia can cause interstitial nephritis; Clinical features can include fever (> 80%), rash (25- 50%), arthralgias, and peripheral blood eosinophilia (80%); The urine often contains red cells (95%), white cells, and white cell casts; Proteinuria can be a feature, particularly in NSAID-induced interstitial nephritis but is usually modest; Eosinophiluria can be detected by Wright"s or Hansel"s stain; Acute interstitial nephritis often carries a good prognosis; Recovery occurs over weeks to months, but acute dialytic therapy may be necessary in up to one-third of all patients before resolution; Patients rarely progress to ESRD; Those with prolonged courses of oliguric failure and advanced age have a worse prognosis; Treatment consists of supportive measures and removal of the inciting agent; If renal failure persists after these steps, a short course of corticosteroids can be given; Short-term, high-dose methylprednisolone 4 days or prednisone 2 weeks followed by a prednisone taper can be used in these more severe cases of drug-induced interstitial nephritis; [CMDXRX2005]------------------.Analgesic variant includes triggers of acetaminophen, propoxyphene and NSAIDS usually; clinically same as with other causes;


External Links Related to Nephritis, analgesic, interstitial
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)