Granulomatous interstitial nephritis: a clinicopathologic study of 46 cases from a single institution

Int J Surg Pathol. 2006 Jan;14(1):57-63. doi: 10.1177/106689690601400110.


Acute interstitial nephritis is commonly seen in kidney biopsies of patients with acute renal failure; however, granulomatous interstitial nephritis (GIN) is rare. We identified 46 cases of GIN in a 17-year period in this institution and we investigated their most probable etiologies. Complete clinical information was available in 38 patients. Seventeen of 38 patients (44.7%) were classified as drug-induced. Renal sarcoidosis was responsible for 28.9% of cases, and the remaining 15.9% of cases included Wegeners granulomatosis, foreign body giant cell reaction, GIN secondary to intravesical bacillus Calmette-Guérin therapy for bladder cancer, and xanthogranulomatous pyelonephritis. Clinical investigation failed to reveal possible etiology in 4 patients (10.5%), classified as idiopathic. We concluded that three quarters of our cases were either drug-induced or due to sarcoidosis; only a small proportion of our cases occurred secondary to any other cause or to unknown factors.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Anti-Bacterial Agents / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • BCG Vaccine / adverse effects
  • BCG Vaccine / therapeutic use
  • Female
  • Foreign-Body Reaction / complications
  • Granuloma / chemically induced
  • Granuloma / etiology*
  • Granuloma / pathology*
  • Granulomatosis with Polyangiitis / complications
  • Humans
  • Male
  • Middle Aged
  • Nephritis, Interstitial / chemically induced
  • Nephritis, Interstitial / etiology*
  • Nephritis, Interstitial / pathology*
  • Pyelonephritis, Xanthogranulomatous / complications
  • Retrospective Studies
  • Sarcoidosis / complications
  • Urinary Bladder Neoplasms / therapy


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • BCG Vaccine