4.2 Article

Renal Involvement as Rare Acute Tubulointerstitial Nephritis in a Patient with Eosinophilic Disorder Treated with Early Add-on Administration of Mepolizumab

Journal

INTERNAL MEDICINE
Volume 60, Issue 23, Pages 3759-3764

Publisher

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.7490-21

Keywords

anti-neutrophil cytoplasmic antibody; eosinophilic granulomatosis with polyangiitis; hypereosinophilic syndrome; mepolizumab; tubulointerstitial nephritis

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A 39-year-old man presented with peripheral eosinophilia, pulmonary eosinophilic infiltrate, and renal failure due to acute tubulointerstitial nephritis (TIN). He was tentatively diagnosed with ANCA-negative EGPA or HES. Despite the rarity, the patient's condition improved well with corticosteroids and mepolizumab.
A 39-year-old man presented with peripheral eosinophilia, pulmonary eosinophilic infiltrate, and renal failure due to acute tubulointerstitial nephritis (TIN). He had experienced childhood asthma and was negative for anti-neutrophil cytoplasmic antibody (ANCA). He was tentatively diagnosed with ANCA-negative eosinophilic granulomatous polyangiitis (EGPA) or idiopathic hypereosinophilic syndrome (HES). Renal involvement of isolated TIN with eosinophil infiltration is rare in EGPA and HES and does not seem to have a good prognosis in the literature. However, his condition improved well with corticosteroids and mepolizumab. The revised classification of EGPA based on the etiology should dictate the proper treatment in suspected EGPA patients with nonsystemic vasculitis.

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