Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (540 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Serum IgA level is increased in ≤50% of patients.
   Serum complement is normal.
   Serum galactose-deficient IgA1 concentration is frequently elevated.
   Serum levels of glycan-specific IgG antibodies have been found to correlate with urinary protein excretion and risk of progression to ESRD or death.
Suggested Reading

Wyatt RJ, Julian BA. IgA nephropathy.
N Engl J Med.
2013;368(25):2402–2414.

INTERSTITIAL NEPHRITIS
   Definition
   This immune-mediated condition is characterized by the presence of inflammatory infiltrate in the kidney interstitium. The onset can be acute or chronic.
   Drug therapy is responsible for more than 75% of acute interstitial nephritis (AIN) cases. The major causative drugs include antibiotics (e.g., beta lactams, cephalosporins, rifampin), sulfonamide diuretics, and NSAIDs.
   Other causes include
   Infections (5–10% of cases): group A β-hemolytic streptococcal infections, diphtheria, brucellosis, leptospirosis, infectious mononucleosis, toxoplasmosis
   Systemic diseases (10–15% of cases): SLE, Sjögren syndrome, sarcoidosis
   Tubulointerstitial nephritis and uveitis (TINU syndrome)
   Toxic substances
   Who Should Be Suspected?

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