Improvement in karyomegalic interstitial nephritis three years after ifosfamide and cisplatin therapy by corticosteroid

Long-term nephrotoxicity of ifosfamide is occasionally progressive, and, in such case, there has been no specific treatment to prevent progression. It has been reported that the presence of karyomegalic interstitial nephritis, which is rare type of interstitial nephritis, may be related to ifosfamide-induced nephropathy with poor prognosis and resistant to the immunosuppressive therapy. A 15-year-old boy presented with progressive nephrotoxicity 3 years after systemic chemotherapy with ifosfamide and cisplatin for the treatment of osteosarcoma. Renal biopsy revealed the severe tubulointerstitial nephritis with tubular atrophy and focal global and segmental glomerular sclerosis. It also showed tubular epithelial cells with variably sized nuclei, some of which were massively enlarged, abnormal hyperchromatic, irregular shaped, and bizarre-appearing. These morphological changes were suggestive of the histology of karyomegalic interstitial nephritis. Corticosteroid retarded the progression of nephrotoxicity. The present case is the first report, suggesting that corticosteroid was effective against the late-onset renal toxicity by ifosfamide therapy. Our case also suggests that karyomegalic interstitial nephritis may be the result of long-term nephrotoxicity of ifosfamide. Since concurrent treatment with cisplatin is one of the risk factors for ifosfamide nephrotoxicity, there is a possibility that cisplatin may have a synergetic effect with ifosfamide for producing karyomegalic interstitial nephritis.

Medienart:

E-Artikel

Erscheinungsjahr:

2014

Erschienen:

2014

Enthalten in:

Zur Gesamtaufnahme - volume:3

Enthalten in:

CEN case reports - 3(2014), 2 vom: 20. Nov., Seite 226-231

Sprache:

Englisch

Beteiligte Personen:

Matsuura, Tomokazu [VerfasserIn]
Wakino, Shu [VerfasserIn]
Yoshifuji, Ayumi [VerfasserIn]
Nakamura, Toshifumi [VerfasserIn]
Tokuyama, Hirobumi [VerfasserIn]
Hashiguchi, Akinori [VerfasserIn]
Konishi, Konosuke [VerfasserIn]
Iwasa, Takeshi [VerfasserIn]
Shoji, Masaaki [VerfasserIn]
Hosono, Ako [VerfasserIn]
Ohashi, Ken [VerfasserIn]
Chuman, Hirokazu [VerfasserIn]
Itoh, Hiroshi [VerfasserIn]

Links:

Volltext

Themen:

Corticosteroid
Ifosfamide
Journal Article
Karyomegalic interstitial nephritis
Long-term nephrotoxicity
Tubulointerstitial nephritis

Anmerkungen:

Date Revised 20.11.2019

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1007/s13730-014-0124-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM271939753