{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T09:28:13Z","timestamp":1765704493351,"version":"3.46.0"},"reference-count":32,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1981,6]]},"abstract":"<jats:p>The clinical and pathological findings are reviewed in ten cases where renal biopsy showed abnormalities predominantly within the interstitium. In six the nephritis was considered to be drug-induced; in two the aetiology was slightly obscure but the most likely diagnosis was considered to be sarcoidosis. Of the remaining two cases one was chronic pyelonephritis and the other polyarteritis nodosa. The diagnosis and pathogenesis of the renal lesions are discussed and attention is drawn to the importance of distinguishing primary interstitial changes from those found in association with glomerular disease.<\/jats:p>","DOI":"10.1136\/jcp.34.6.616","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"616-624","source":"Crossref","is-referenced-by-count":9,"title":["Interstitial nephritis."],"prefix":"10.1136","volume":"34","author":[{"given":"A J","family":"Dixon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C G","family":"Winearls","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M S","family":"Dunnill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1981,6,1]]},"reference":[{"key":"ref_1","article-title":"Sulphonamides Penicillin Methicillin Ampicillin Cotrimoxazole Cephalosporins Rifampicin Ethambutol Phenindione Diphenylhydantoin Furosemide Phenylbutazone Allopurinol Diflunisal Phenobarbitol Robson","author":"Mayaud et al. (1975)' Ruley et al.","year":"1968","unstructured":"Sulphonamides Penicillin Methicillin Ampicillin Cotrimoxazole Cephalosporins Rifampicin Ethambutol Phenindione Diphenylhydantoin Furosemide Phenylbutazone Allopurinol Diflunisal Phenobarbitol Robson et al. (1970)' Baldwin et al. (1968),' MWry (1970)' Border ct al. (1974),' Mayaud et al. (1975)' Ruley et al. (1974)8","journal-title":"et al. (1970)' Baldwin et al; 1970)' Border ct al. (1974"},{"key":"ref_2","author":"Dry","year":"1975","unstructured":"Dry et al. (1975)9 Burton et al. (1974),1\" Wiles et al. (1979)\" Nessi et at. (1976)12 Collier et al. (1976)","journal-title":"Wiles et al. (1979)\" Nessi et at"},{"key":"ref_3","article-title":"Muehrcke and Pirani (1972)\"","author":"Sraer","year":"1972","unstructured":"Sraer et al. (1972)14 Muehrcke and Pirani (1972)\" Lyons et al. (1973)\" Russell et al. (1978)1\" Gelbart et al. (1977)\"1 Chan et al. (1980)\" Faarup and Christenson (1974)2","journal-title":"Lyons et al. (1973)\" Russell et al. (1978)1\" Gelbart et al"},{"article-title":"Interstitial nephritis without glomerular disease may be found in association with a number of conditions.' Its aetiology may be difficult if not impossible to determine on biopsy alone. Reliance on clinical and radiological evidence is often required, particularly in diagnosing conditions such as pyelonephritis, renal papillary necrosis or urinary tract obstruction, all of which may result in substantial inflammatory cell infiltration of the renal interstitium","year":"9.","key":"ref_4","unstructured":"Interstitial nephritis without glomerular disease may be found in association with a number of conditions.' Its aetiology may be difficult if not impossible to determine on biopsy alone. Reliance on clinical and radiological evidence is often required, particularly in diagnosing conditions such as pyelonephritis, renal papillary necrosis or urinary tract obstruction, all of which may result in substantial inflammatory cell infiltration of the renal interstitium. This is illustrated by case 9."},{"key":"ref_5","unstructured":"Tubular damage can be associated with deposition of immunoglobulins and complement components on the tubular basement membrane. This has been reported in systemic lupus erythematosus23 and in rapidly progressive glomerulonephritis where it is associated with circulating antiglomerular and antitubular basement membrane antibodies.24 Antitubular basement membrane antibodies may also be responsible for tubulointerstitial damage occurring in some renal allografts. They have been reported to occur in association with tubular damage due to methicillin6 but have not been found in many other instances of drug-induced disease. There was some evidence of a similar mechanism in two of our cases.","article-title":"Tubular damage can be associated with deposition of immunoglobulins and complement components on the tubular basement membrane. This has been reported in systemic lupus erythematosus23 and in rapidly progressive glomerulonephritis where it is associated with circulating antiglomerular and antitubular basement membrane antibodies.24 Antitubular basement membrane antibodies may also be responsible for tubulointerstitial damage occurring in some renal allografts. They have been reported to occur in association with tubular damage due to methicillin6 but have not been found in many other instances of drug-induced disease. There was some evidence of a similar mechanism in two of our cases"},{"key":"ref_6","unstructured":"Interstitial nephritis was more frequently referred to in early literature before the antibiotic era, usually in association with infectious fevers.26 These patients differed from most of the recently reported cases in that functional disturbance was minimal. Yet many patients with interstitial nephritis are suffering from infections either in the urinary tract or elsewhere in the body. Treatment of these patients with antibiotics must leave some doubt as to the part played by the underlying infection and the role of antibiotics themselves in the aetiology of the renal disease.","article-title":"Interstitial nephritis was more frequently referred to in early literature before the antibiotic era, usually in association with infectious fevers.26 These patients differed from most of the recently reported cases in that functional disturbance was minimal. Yet many patients with interstitial nephritis are suffering from infections either in the urinary tract or elsewhere in the body. Treatment of these patients with antibiotics must leave some doubt as to the part played by the underlying infection and the role of antibiotics themselves in the aetiology of the renal disease"},{"key":"ref_7","first-page":"214","article-title":"Interstitial nephritis","volume":"83","author":"Heptinstall, R.H.","year":"1976","unstructured":"Heptinstall RH. Interstitial nephritis. Am J Pathol 1976; 83:214-36.","journal-title":"Am J Pathol"},{"key":"ref_8","first-page":"614","article-title":"Acute interstitial nephritis. A clinical and pathologic study based on renal biopsies","volume":"59","author":"Ooi, B.S.; Wellington, J.; Jao, W.; First, M.R.; Mancilla, R.; Pollak, V.E.","year":"1975","unstructured":"Ooi BS, Wellington J, Jao W, First MR, Mancilla R, Pollak VE. Acute interstitial nephritis. A clinical and pathologic study based on renal biopsies. Am J Med 1975; 59:614-29.","journal-title":"Am J Med"},{"key":"ref_9","first-page":"561","article-title":"Acute tubulo-interstitial nephritis following sulfadiazine therapy","volume":"6","author":"Robson, M.; Levi, J.; Dolberg, L.; Rosenfeld, J.B.","year":"1970","unstructured":"Robson M, Levi J, Dolberg L, Rosenfeld JB. Acute tubulo-interstitial nephritis following sulfadiazine therapy. Isr J Med Sci 1970;6:561-6.","journal-title":"Isr J Med Sci"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1056\/NEJM196812052792302","article-title":"Renal failure and interstitial nephritis due to penicillin and methicillin","volume":"279","author":"Baldwin, D.S.; Levin, B.B.; McCluskey, R.T.; Gallo, G.","year":"1968","unstructured":"Baldwin DS, Levin BB, McCluskey RT, Gallo G. Renal failure and interstitial nephritis due to penicillin and methicillin. N Engl J Med 1968;279:1245-52.","journal-title":"N Engl J Med"},{"key":"ref_11","first-page":"811","article-title":"Les nephropathies interstitielles aigues provoqu6es par les p6nicillines","volume":"121","author":"J-Ph, Mery","year":"1970","unstructured":"Mery J-Ph. Les nephropathies interstitielles aigues provoqu6es par les p6nicillines. Ann Med Interne (Paris) 1970;121:811-6.","journal-title":"Ann Med Interne (Paris)"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1056\/NEJM197408222910803","article-title":"Antitubular basement membrane antibodies in methicillin nephritis","volume":"291","author":"Border, W.A.; Lehman, D.H.; Egan, J.D.; Sass, H.J.; Glode, J.E.; Wilson, C.B.","year":"1974","unstructured":"Border WA, Lehman DH, Egan JD, Sass HJ, Glode JE, Wilson CB. Antitubular basement membrane antibodies in methicillin nephritis. NEnglJ Med 1974;291:381-4.","journal-title":"NEnglJ Med"},{"key":"ref_13","first-page":"11323","article-title":"Interstitial nephritis after methicillin","volume":"292","year":"1975","unstructured":"Mayaud C, Kanfer A, Kourilsky 0, Sraer JD. Interstitial nephritis after methicillin. N Engl J Med 1975;292:11323.","journal-title":"N Engl J Med"},{"key":"ref_14","first-page":"873","article-title":"Interstitial nephritis and renal failure due to ampicillin","volume":"84","author":"Ruley, E.J.; Lisi, L.M.","year":"1974","unstructured":"Ruley EJ, Lisi LM. Interstitial nephritis and renal failure due to ampicillin. J Pediatr 1974;84:873-7.","journal-title":"J Pediatr"},{"key":"ref_15","first-page":"36","article-title":"L'association sulfamethoxazole trimethoprime (cotrimoxazole). Reaction immuno-allergique inhabituelle","volume":"4","author":"Dry, J.; Leynadier, F.; Herman, D.; Pradalier, A.","year":"1975","unstructured":"Dry J, Leynadier F, Herman D, Pradalier A. L'association sulfamethoxazole trimethoprime (cotrimoxazole). Reaction immuno-allergique inhabituelle. Nouv Presse Med 1975;4:36.","journal-title":"Nouv Presse Med"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1001\/jama.1974.03230440037028","article-title":"Acute renal failure during cephalothin therapy","volume":"229","author":"Burton, JR, Lichtenstein; NS, Colin; RB, Jr, Hyslop N.E.","year":"1974","unstructured":"Burton JR, Lichtenstein NS, Colin RB, Hyslop NE Jr. Acute renal failure during cephalothin therapy. JAMA 1974;229:679-82.","journal-title":"JAMA"},{"key":"ref_17","first-page":"342","article-title":"Cephradineinduced interstitial nephritis. Clin Exp Immnol","volume":"36","author":"Wiles, C.M.; Assem, E.S.K.; Cohen, S.L.; Fisher, C.","year":"1979","unstructured":"Wiles CM, Assem ESK, Cohen SL, Fisher C. Cephradineinduced interstitial nephritis. Clin Exp Immnol 1979;36: 342-6."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1159\/000180596","article-title":"Acute renal failure after rifampicin: a case report and survey of the literature","volume":"16","author":"Nessi, R.; Bonoldi, G.L.; Redaelli, B.; Di Filippo, G.","year":"1976","unstructured":"Nessi R, Bonoldi GL, Redaelli B, Di Filippo G. Acute renal failure after rifampicin: a case report and survey of the literature. Nephron 1976;16:148-59.","journal-title":"Nephron"},{"key":"ref_19","first-page":"1105","article-title":"Two cases of ethambutol nephrotoxicity","volume":"ii:","author":"Collier, J.; Joekes, A.M.; Philalithis, P.E.; Thompson, F.D.","year":"1976","unstructured":"Collier J, Joekes AM, Philalithis PE, Thompson FD. Two cases of ethambutol nephrotoxicity. Br Med J 1976;ii: 1105-6.","journal-title":"Br Med J"},{"key":"ref_20","first-page":"193","article-title":"Nephrite interstitielle chronique due a la phenylindanedione faisant suite a une insufficience renale aigue","volume":"1","author":"Sraer, J.D.; Beaufils, P.; Morel-Maroger, L.; Richet, G.","year":"1972","unstructured":"Sraer JD, Beaufils P, Morel-Maroger L, Richet G. Nephrite interstitielle chronique due a la phenylindanedione faisant suite a une insufficience renale aigue. Noiov Presse Med 1972;1:193-6.","journal-title":"Noiov Presse Med"},{"key":"ref_21","first-page":"110","article-title":"Renal biopsy: an adjunct in the study of kidney disease. In Black DAK, ed. Renal disease","author":"Muehrcke, R.C.; Pirani, C.L.","year":"1972","unstructured":"Muehrcke RC, Pirani CL. Renal biopsy: an adjunct in the study of kidney disease. In Black DAK, ed. Renal disease. 3rd ed. Oxford, London, Edinburgh: Blackwell Scientific Publications, 1972:110-53.","edition":"3rd ed"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1056\/NEJM197301182880304","article-title":"Allergic interstitial nephritis causing reversible renal failure in four patients with idiopathic nephrotic syndrome","volume":"288","author":"Lyons, H.; Pinn, V.W.; Cortell, S.; Cohen, J.J.; Harrington, J.T.","year":"1973","unstructured":"Lyons H, Pinn VW, Cortell S, Cohen JJ, Harrington JT. Allergic interstitial nephritis causing reversible renal failure in four patients with idiopathic nephrotic syndrome. N EngI J Med 1973;288:124-8.","journal-title":"N EngI J Med"},{"key":"ref_23","first-page":"1322","article-title":"Interstitial nephritis in a case of phenylbutazone hypersensitivity","volume":"i:","author":"Russell, G.I.; Bing, R.F.; Walls, J.; Pettigrew, N.M.","year":"1978","unstructured":"Russell GI, Bing RF, Walls J, Pettigrew NM. Interstitial nephritis in a case of phenylbutazone hypersensitivity. Br Med J 1978;i: 1322.","journal-title":"Br Med J"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"196","DOI":"10.7326\/0003-4819-86-2-196","article-title":"Allopurinolinduced interstitial nephritis","volume":"86","author":"Gelbart, D.R.; Weinstein, A.B.; Fajardo, L.F.","year":"1977","unstructured":"Gelbart DR, Weinstein AB, Fajardo LF. Allopurinolinduced interstitial nephritis. Ann Intern Med 1977;86: 196-8.","journal-title":"Ann Intern Med"},{"key":"ref_25","first-page":"84","article-title":"Acute interstitial nephritis and erythroderma associated with difiunisal","volume":"i:","author":"Chan, L.K.; Winearls, C.G.; Oliver, D.O.; Dunnill, M.S.","year":"1980","unstructured":"Chan LK, Winearls CG, Oliver DO, Dunnill MS. Acute interstitial nephritis and erythroderma associated with difiunisal. Br MedJ 1980;i:84-5.","journal-title":"Br MedJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/S0140-6736(74)93292-9","article-title":"IgE containing plasma cells in acute tubulointerstitial nephropathy","volume":"ii:","author":"Faarup, P.; Christenson, E.","year":"1974","unstructured":"Faarup P, Christenson E. IgE containing plasma cells in acute tubulointerstitial nephropathy. Lancet 1974;ii:718.","journal-title":"Lancet"},{"key":"ref_27","first-page":"1110","article-title":"Renal failure due to glomerulonephritis in sarcoidosis","volume":"i:","author":"Waldek, S.; Agius-Ferrante, A.M.; Lawler, W.","year":"1978","unstructured":"Waldek S, Agius-Ferrante AM, Lawler W. Renal failure due to glomerulonephritis in sarcoidosis. Br MedJ 1978; i: 1110-1.","journal-title":"Br MedJ"},{"key":"ref_28","article-title":"Pathologs' of the kidnei","author":"Heptinstall, R.H.","year":"1974","unstructured":"Heptinstall RH. Pathologs' of the kidnei. 2nd ed. Boston: Little, Brown and Co, 1974.","edition":"2nd ed"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1038\/ki.1975.38","article-title":"Tubular and interstitial renal disease due to immunologic mechanisms","volume":"7","author":"Andres, G.A.; McCluskey, R.T.","year":"1975","unstructured":"Andres GA, McCluskey RT. Tubular and interstitial renal disease due to immunologic mechanisms. Kidnej Int 1975;7:271-89.","journal-title":"Kidnej Int"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1038\/ki.1978.71","article-title":"Histology of human tubulo-interstitial nephritis associated with antibodies to renal basement membranes","volume":"13","author":"Andres, G.; Brentjens, J.; Kohli, R.","year":"1978","unstructured":"Andres G, Brentjens J, Kohli R, et al. Histology of human tubulo-interstitial nephritis associated with antibodies to renal basement membranes. Kidne i Int 1978;13:480-91.","journal-title":"Kidne i Int"},{"issue":"3","key":"ref_31","first-page":"\"524","article-title":"Acute interstitial nephritis. A hypersensitivity reaction to drugs","volume":"1898","author":"J-Ph, Mry; L, Morel-Maroger","year":"1975","unstructured":"Mry J-Ph, Morel-Maroger L. Acute interstitial nephritis. A hypersensitivity reaction to drugs. In: Giovannetti S, Bonomini V, D'Amico G, eds. Proceeedings of the 6th international congress on nephrologv, Florenc e 1975. Basel: Karger, 1976:524-9. t Councilman WT. Acute interstitial nephritis. J E.xp Med 1898;3:393-420.","journal-title":"Proceeedings of the 6th international congress on nephrologv; J E.xp Med; t Councilman WT. Acute interstitial nephritis"},{"key":"ref_32","first-page":"542","volume-title":"Proc-eedings of the 6th international congress on nephrologv, Florence","author":"nephritides. In, Freedman L.R.Interstitial","year":"1975","unstructured":"Freedman LR. Interstitial nephritides. In: Giovanetti S, Bonomini V, D'Amico G, eds. Proc-eedings of the 6th international congress on nephrologv, Florence 1975. Basel: Karger, 1976:542-51."}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.34.6.616","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:48:53Z","timestamp":1764996533000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.34.6.616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1981,6]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1981,6,1]]},"published-print":{"date-parts":[[1981,6]]}},"alternative-id":["10.1136\/jcp.34.6.616"],"URL":"https:\/\/doi.org\/10.1136\/jcp.34.6.616","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1981,6]]}}}