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Diagnose This! (May 14, 2018)

By L. Nich Cossey, MD

May 14, 2018

Acute Interstitial Nephritis
Camera information: Calibration= 1.000 Pixels per pixel; Capture format= 1392 x 1040, Full Frame HQ; Gamma= 0.70; Gain= 1.0 x; Exposure= 4.87 ms; Auto exposure= On; Image type= Colour; Shading= (None); Sharpening= Off; Black clip= 10; White clip= 234; Microscope information:

What is your diagnosis? 

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Acute Interstitial Nephritis

The images show lymphocytic tubulitis as well as an eosinophil-rich interstitial inflammatory infiltrate. These findings are consistent with acute interstitial nephritis. The eosinophil-rich nature of the infiltrate is compatible with a drug/hypersensitivity reaction which was present in this patient, occurring from recent antibiotics exposure with subsequent acute renal failure and development of a rash.

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