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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Kidney+J
2017 ; 10
(2
): 240-248
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English Wikipedia
Renal allograft granulomatous interstitial nephritis: observations of an uncommon
injury pattern in 22 transplant recipients
#MMPMID28396741
Farris AB
; Ellis CL
; Rogers TE
; Chon WJ
; Chang A
; Meehan SM
Clin Kidney J
2017[Apr]; 10
(2
): 240-248
PMID28396741
show ga
Background: Granulomatous interstitial nephritis (GIN) is uncommon in native
kidneys, and descriptions in allografts are few. We report clinical and
pathologic findings in 22 allograft recipients with GIN identified in renal
allograft biopsies and nephrectomies. Methods: Renal allografts with GIN were
retrieved from the pathology files of two academic medical centers. Available
clinical and pathologic data were compiled retrospectively for a 23-year period.
Results: GIN was present in 23 specimens from 22 patients (15 males and 7
females) with allograft dysfunction [serum creatinine averaged 3.3?mg/dL (range
1.4-7.8)], at a mean age of 48 years (range 22-77). GIN was identified in 0.3% of
biopsies at a mean of 552 days post transplantation (range 10-5898). GIN was due
to viral (5), bacterial (5) and fungal (2) infections in 12 (54.5%), and drug
exposure was the likely cause in 5 cases (22.7%). One had recurrent
granulomatosis with polyangiitis. In 4 cases, no firm etiology of GIN was
established. Of 18 patients with follow up data, 33.3% had a complete response to
therapy, 44.5% had a partial response and 22.2% developed graft loss due to
fungal and E. coli infections. All responders had graft survival for more than 1
year after diagnosis of GIN. Conclusions: Allograft GIN is associated with a
spectrum of etiologic agents and was identified in 0.3% of biopsies. Graft
failure occurred in 22% of this series, due to fungal and bacterial GIN; however,
most had complete or partial dysfunction reversal and long-term graft survival
after appropriate therapy.