A Case of Crohn's disease with Granulomatous Interstitial Nephritis as an Extraintestinal Complication from the Time of the Diagnosis

Intern Med. 2024 Dec 19. doi: 10.2169/internalmedicine.4335-24. Online ahead of print.

Abstract

Granulomatous interstitial nephritis (GIN) has been reported in <0.5% of patients with inflammatory bowel disease, and most cases of GIN are drug-induced. A 13-year-old boy was referred for the evaluation of abdominal pain, diarrhea, and weight loss. The patient was diagnosed with non-drug-induced GIN and Crohn's disease based on total colonoscopy and a biopsy of the colon and kidney. Both tissues contained macrophages and increased epithelial expression of IκBζ, a protein involved in the NF-κB pathway. There may be more patients with GIN complicated by Crohn's disease than expected, and macrophages may be involved in the pathogenesis.

Keywords: Crohn's disease; NFKBIZ; granulomatous interstitial nephritis; inflammatory bowel disease; macrophage.