PREDOMINANT TUBULOINTERSTITIAL LUPUS NEPHRITIS

Predominant tubulointerstitial lupus nephritis is rare, Only eight cas es have been described in the literature, We report the case of a 59-y ear-old man with systemic lupus erythematosus who presented with acute renal failure. On renal biopsy, he was found to have chronic tubuloin terstitial nephritis with a mononuclear infiltrate, The immunofluoresc ence showed immune deposits in the tubular basement membranes, interst itium, and glomerular capsule, The glomeruli were minimally involved, He was initially treated with high-dose corticosteroids and supported with hemodialysis. Renal function improved and dialysis was discontinu ed after three treatments, The corticosteroid dosage was gradually tap ered, Renal function after 72 months of follow-up has remained stable (serum creatinine, approximately 1.9 mg/dL) and except for one relapse , there has been no clinical or serologic evidence of lupus activity, Furthermore, 24-hour urinary protein excretion has remained within the normal range. (C) 1996 by the National Kidney Foundation, Inc.