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Potential Risks of Drug Allergy: How Is Interstitial Nephritis Related to Your Medications?
Interstitial nephritis, also known as tubulointerstitial nephritis, is inflammation of a specific area inside the kidney called the interstitium, which is composed of cells, extracellular matrix, and fluid that surrounds the kidney tubules The aggregate composed of. This disease may have clinical manifestations similar to intestinal lymphadenitis in some cases of acute pyelonephritis, primarily due to the use of nonsteroidal anti-inflammatory drugs. The course of interstitial nephritis may progress from an acute lesion to a chronic condition, resulting in a progressive loss of kidney function.
The causes of interstitial nephritis are diverse, including drug reactions, environmental factors, infections, and systemic diseases.
Signs and symptoms
Often, the symptoms of interstitial nephritis are very nonspecific. The most common symptom is fever, which occurs in 30% to 50% of patients, especially those with drug-induced nephritis. Some other common symptoms include nausea, vomiting, fatigue, loss of appetite and weight loss. In some cases, people with nephritis may experience symptoms such as flank pain, pain during urination, and blood in the urine.
Some studies have pointed out that the most common "triad" includes rash, joint pain, and increased eosinophils in the blood. However, this combination of symptoms actually occurs in only 5% to 10% of patients.
Cause
Common causes of interstitial nephritis include infection or drug reactions, with drug reactions accounting for 71% to 92% of cases. A wide variety of drugs can cause kidney damage, including beta-lactam antibiotics (such as penicillin and cefradine), nonsteroidal anti-inflammatory drugs (such as aspirin), and some proton pump inhibitors. The potential time frame for drug-induced nephritis can range from 5 days to 5 months.
Diagnosis
During the diagnostic process, symptomatic patients may develop hypereosinophilia and eosinophils may appear in the urine, demonstrating its specificity and sensitivity. Kidney biopsy is the only way to confirm interstitial nephritis. Pathological examination results will show interstitial edema and inflammatory infiltration of white blood cells.
In addition to traditional blood and urine tests, there has also been research in recent years on targeting new markers for more effective diagnosis of this disease.
Treatment methods
For interstitial nephritis, the first step is to treat the cause, such as discontinuing the drug that causes nephritis. Although corticosteroids are sometimes used to treat this type of nephritis, there is currently no conclusive evidence of their efficacy. Adequate hydration is also an integral part of treatment.
Prognosis
The impact on kidney function may vary depending on the acute or chronic infection of nephritis. In acute interstitial nephritis, kidney function usually recovers after the offending drug is discontinued or the underlying disease is treated. Serious long-term consequences of chronic nephritis include kidney failure, and some patients may require dialysis or even a kidney transplant.
Corticosteroids may speed recovery of kidney function in some patients with allergic reactions, but not all patients are candidates for this treatment.
According to statistics, interstitial nephritis is uncommon in patients without clear symptoms, but its incidence in patients with acute kidney injury is as high as 10% to 15%. With the development of science and technology, our understanding of nephritis and its diagnosis and treatment have improved significantly, but it is still one of the recovery challenges faced by many patients.
Do you know enough about your daily medications to understand the potential risks associated with drug allergies?
