Relapsing Tubulointerstitial Nephritis with Antimitochondrial M2 Antibody Accompanied by Pulmonary Involvement

Intern Med. 2020 May 1;59(9):1179-1187. doi: 10.2169/internalmedicine.4048-19. Epub 2020 Feb 12.

Abstract

We herein report a 50-year-old woman who suffered from tubulointerstitial nephritis with antimitochondrial M2 antibody, distal renal tubular acidosis, and Fanconi syndrome. Our case also had interstitial pneumonia. After initially successful glucocorticoid therapy, tubulointerstitial nephritis and interstitial pneumonia relapsed. After the second successful round of glucocorticoid therapy, tubulointerstitial nephritis relapsed again and responded to glucocorticoid and azathioprine. This case might indicate (1) the association between pulmonary involvement and tubulointerstitial nephritis with antimitochondrial antibodies and (2) the need for a maintenance dose of glucocorticoid and immunosuppressants in tubulointerstitial nephritis with antimitochondrial antibodies.

Keywords: Fanconi syndrome; antimitochondrial antibodies; distal renal tubular acidosis; immunosuppressant; pulmonary involvement; tubulointerstitial nephritis.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Renal Tubular / complications
  • Acidosis, Renal Tubular / diagnosis*
  • Acidosis, Renal Tubular / drug therapy
  • Autoantibodies / blood
  • Diagnosis, Differential
  • Fanconi Syndrome / complications
  • Fanconi Syndrome / diagnosis*
  • Fanconi Syndrome / drug therapy
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnosis*
  • Lung Diseases, Interstitial / drug therapy
  • Middle Aged
  • Mitochondria / immunology*
  • Nephritis, Interstitial / complications
  • Nephritis, Interstitial / diagnosis*
  • Nephritis, Interstitial / drug therapy
  • Recurrence

Substances

  • Autoantibodies
  • Glucocorticoids