Tubulo-interstitial diseases

Question 1

Sjogren syndrome

Answer 1

Sjögren’s syndrome (SS) is a chronic autoimmune inflammatory disorder characterized by diminished lacrimal and salivary gland function with resultant dryness of the eyes and mouth

The most common diseases associated with secondary SS are rheumatoid arthritis and systemic lupus erythematosus

diagnosis of Sjögren’s syndrome (SS) should be suspected in individuals with persistent symptoms of dry eyes and/or mouth, parotid gland enlargement, an unexplained increase in dental caries, or abnormal results of specific serologic tests (eg, anti-Ro/SSA and/or anti-La/SSB antibodies, rheumatoid factor, and hyperglobulinemia)

can effect the kidneys and result in granuloma formation and interstitial damage

Question 2

Sarcoidosis

Answer 2

Sarcoidosis is a multisystem disorder of unknown etiology characterized by the accumulation of T lymphocytes, mononuclear phagocytes, and noncaseating granulomas in involved tissues

can cause kidney granulomas
confirm by biopsy

Question 3

Lupus Erythematosus

Answer 3

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect virtually every organ. Immunologic abnormalities, particularly the production of a number of antinuclear antibodies, are another prominent feature of the disease. Women are affected more frequently than men

can affect the kidneys
typically causes a glomerular nephritis as well

Question 4

infections leading to tubulointersitial disease

Answer 4

BK virus -common post renal transplant

CMV
EBV
Fungal infections

Question 5

Medications that cause tubulointersitial disease

Answer 5

analgesic nephropathy

calcineurin inhibitors
COX-2 inhibitors