Def. Interstitial inflammation resulting in !AKI - Acute Kidney Injury

Etiology:

1. Allergic Reaction to Medication (Major) → Often delayed onset (7 days)
   1. PPI (”-prazole”) (widely prescribed)
   2. NSAID → Can take months to develop reaction
   3. Anti-Microbial (esp. Penicillin G/V)
2. Autoimmune
   1. Sjogren’s Disease
   2. Sarcoidosis
   3. IgG4-related disease (IgG4-RD)
   4. SLE - Lupus

Presentation

• Management → supportive! Stop agent. Consider steroids if select cases

Signs and Symptoms

• Presentation → 1 week - months after Rx
• Skin Rashes
• Fever
• ElevatedEosinophil

Investigation

• Should do detailed drug Hx (avoid drug allergy)
• Urine Analysis : Hematuria, non-nephrotic rangeProteinuria, Pyuria (Mainly eosinophil)
• Urine microscopy : WBC Cast

Management

• Remove the inciting medication
• Supportive care
• Early Oral Corticosteroid (OCS) may help