Acute Kidney Injury in the Context of Inflammatory Bowel Disease - A Clinical Case

• Autor(a) principal: Cristóvão Marques, J
• Data de Publicação: 2021
• Outros Autores: Barata, R, Lemos Garcia, J, Navarro, D, Góis, M, Sousa, H, Cotovio, P, Ribeiro, F, Nolasco, F
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/4360
• topic: Inflammatory bowel disease; kidney injury/acute; IgA nephropathy; Tubulointerstitial nephritis; Mesalazine; HCC PAT CLIN; HCC NEF

Extraintestinal manifestations of inflammatory bowel disease are common and extendable to all organs. Kidney and lower genitourinary system occurs in 4-23% of cases. This may be dependent on inflammatory bowel disease activity, secondary to metabolic disorders, drugs or others. We present a case of a 68-year-old man with ulcerative colitis for 22 years admitted in our department for acute nephritic syndrome. Urinary microscopy suggested glomerular injury. A kidney biopsy was performed and was compatible with acute interstitial nephritis and IgA nephropathy. Toxicity of mesalazine and glomerulonephritis secondary to ulcerative colitis were assumed. The patient suspended mesalazine and started prednisolone with clinical improvement. Our purpose is to sensitize the importance of having a prompt and thorough evaluation of acute kidney injury in patients with inflammatory bowel disease. We briefly review the broad spectrum of kidney manifestations in this population, focusing on mesalazine-induced nephrotoxicity.