Tubulointerstitial Nephritis Caused by Peritubular Capillaritis Accompanied by Cryoglobulinemia

Intern Med. 2015;54(22):2885-91. doi: 10.2169/internalmedicine.54.5015. Epub 2015 Nov 15.

Abstract

A 73-year-old man with fever, renal insufficiency, and purpura was referred to our hospital to be evaluated for renal insufficiency. Renal biopsy revealed acute and chronic tubulointerstitial nephritis with no laboratory findings of sarcoidosis or connective tissue disease. Low C4 levels and elevation of rheumatoid factors suggested cryoglobulinemia, which was confirmed with quantitative analysis. CD34 staining of kidney tissue revealed peritubular capillaritis. Antineutrophil cytoplasmic antibodies were negative. The etiology of peritubular capillaritis was not clear in our patient; however, it might be associated with cryoglobulinemia because we cannot find any other diseases that could have induced the peritubular capillaritis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / metabolism*
  • Capillaries / pathology
  • Cryoglobulinemia / complications
  • Cryoglobulinemia / drug therapy
  • Cryoglobulinemia / pathology*
  • Humans
  • Male
  • Nephritis, Interstitial / etiology
  • Nephritis, Interstitial / pathology*
  • Renal Insufficiency / etiology
  • Renal Insufficiency / pathology*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Antineutrophil Cytoplasmic