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Pediatric Nephrology
Published in: Pediatric Nephrology 4/2020

01-04-2020 | Acute Kidney Injury | Review

Drug-induced tubulointerstitial nephritis: hypersensitivity and necroinflammatory pathways

Author: Allison A. Eddy

Published in: Pediatric Nephrology | Issue 4/2020

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Abstract

More than 250 drugs carry a small but important dose-independent risk of initiating a delayed-type hypersensitivity reaction that leads to acute tubulointerstitial nephritis (TIN). Clinical manifestations are often non-specific, making epidemiological studies challenging. In severe cases, if cessation of the offending drug is not followed by a prompt improvement in renal function, corticosteroid therapy appears to enhance renal recovery rates. Other drugs, classified as potential nephrotoxins, may induce dose-dependent acute tubular necrosis. Studies over the past decade have identified a unique form of tubular cell death called “necroptosis” that is accompanied by a specific and significant interstitial inflammatory response to certain insults, including some nephrotoxins. Insights into the molecular basis of this necroinflammatory pathway have emerged. There is still a paucity of pediatric data on these two distinct types of drug-induced TIN. Early recognition is essential to minimize the risk of chronic kidney damage.
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Metadata
Title
Drug-induced tubulointerstitial nephritis: hypersensitivity and necroinflammatory pathways
Author
Allison A. Eddy
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 4/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04207-9

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