Pathological evidence of rhabdomyolysis-induced acute tubulointerstitial nephritis accompanying Legionella pneumophila pneumonia. Issue 9 (13th June 2008)

• Record Type: Journal Article
• Authors: Shimura, C; Saraya, T; Wada, H; Takata, S; Mikura, S; Yasutake, T; Kato, J; Kato, A; Yamamoto, M; Watanabe, M; Yokoyama, T; Kurai, D; Ishii, H; Aoshima, M; Yamada, A; Goto, H
• Is Part Of: Journal of clinical pathology. Volume 61:Issue 9(2008)
• Page Start: 1062
• Page End: 1063
• Publication Date: 2008-06-13
• Subjects: Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jcp.2008.057000
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : A case of Legionella pneumophila pneumonia with rhabdomyolysis-induced acute tubulointerstitial nephritis (ATIN) and prolonged renal dysfunction is presented. The patient was a 54-year-old man, admitted with high-grade fever, ataxia and muscle dysfunction; chest roentgenogram showed multilobular infiltrations. L pneumophila was detected in his sputum and urine, by PCR and by culture, and L pneumophila pneumonia was diagnosed. Despite antimicrobial treatment, he developed renal failure and rhabdomyolysis. Renal biopsy showed the presence of myoglobin casts that occluded the distal tubuli and tubulointerstitial nephritis, leading to the diagnosis of rhabdomyolysis-induced ATIN. Renal function subsequently normalised, and he was discharged. This is believed to be the first pathological evidence of involvement of rhabdomyolysis in legionellosis-associated ATIN.