THE SYNDROME OF AUTOIMMUNE INTERSTITIAL NEPHRITI AND MEMBRANOUS NEPHROPATHY

A 2-year-old male patient was evaluated for Fanconi syndrome with hype rtension and failure to thrive, Renal biopsy revealed autoimmune inter stitial nephritis with membranous nephropathy. The patient developed a utoimmune hemolytic anemia and intractable diarrhea with villous atrop hy of the jejunum. He progressed to end-stage renal disease and was tr ansplanted without recurrent disease. Immune work-up done prior to imm unosuppressive therapy showed marked elevation of IgE. Studies of T ly mphocyte cytokine production showed normal production of interleukin-4 but depressed levels of interferon-gamma. The simultaneous occurrence of autoimmune interstitial nephritis and membranous nephropathy in a young male represents a unique syndrome. Abnormalities of T lymphocyte subpopulations and their cytokines may be involved in the pathogenesi s of this disorder.