Acute tubulointerstitial nephritis complicating Legionnaires' disease: a case report

Journal of Medical Case Reports

Noémie Jourde-Chiche⁴  Yvon Berland⁴  Bertrand Dussol⁴  Stéphane Burtey⁴  Pierre-Edouard Fournier¹  Jean-Marie Caporossi³  Laurent Daniel²  Stanislas Bataille⁴  Fadwa El-Mekaoui⁴  Aurélie Daumas⁴ 

[1] Fédération de Microbiologie Clinique, Assistance Publique des Hôpitaux de Marseille (AP-HM), Hôpital de la Timone, 264 rue Saint Pierre, Marseille, and Unité des Rickettsies, Faculté de Médecine, CNRS-IRD UMR6020, F-13005 Marseille, France;Service d'anatomopathologie, Assistance Publique des Hôpitaux de Marseille (AP-HM), Hôpital de la Timone, 264 rue Saint Pierre, F-13005 Marseille, France;Service de Radiologie, Assistance Publique des Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Bd Baille, F-13005 Marseille, France;Service de Néphrologie, Dialyse et Transplantation rénale, Assistance Publique des Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Bd Baille, F-13005 Marseille, France

关键词: renal biopsy;    tubulointerstitial nephritis;    acute renal failure;    Legionnaires' disease;   

Others  :  1195860
DOI  :  10.1186/1752-1947-6-100

 received in 2011-10-18, accepted in 2012-04-04,  发布年份 2012

【 摘 要 】

Introduction

Legionnaires' disease is recognized as a multi-systemic illness. Afflicted patients may have pulmonary, renal, gastrointestinal tract and central nervous system complications. However, renal insufficiency is uncommon. The spectrum of renal involvement may range from a mild and transient elevation of serum creatinine levels to anuric renal failure requiring dialysis and may be linked to several causes. In our present case report, we would like to draw attention to the importance of the pathological documentation of acute renal failure by reporting a case of a patient with acute tubulointerstitial nephritis complicating Legionnaires' disease.

Case presentation

A 55-year-old Caucasian man was admitted to our hospital for community-acquired pneumonia complicated by acute renal failure. Legionella pneumophila serogroup type 1 was diagnosed. Although the patient's respiratory illness responded to intravenous erythromycin and ofloxacin therapy, his renal failure worsened, he became anuric, and hemodialysis was started. A renal biopsy was performed, which revealed severe tubulointerstitial nephritis. After initiation of steroid therapy, his renal function improved dramatically.

Conclusions

This case highlights the importance of kidney biopsies in cases where acute renal failure is a complicating factor in Legionnaires' disease. If the presence of acute tubulointerstitial nephritis can be confirmed, it will likely respond favorably to steroidal treatment and thus irreversible renal damage and chronic renal failure will be avoided.

【 授权许可】

   
2012 Daumas et al; licensee BioMed Central Ltd.

【 图 表 】

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