Uncommon cause of progressive renal function decline
Abstract
Whenever there is a 50% drop in glomerular filtration over 3 months we are in the presence of what is defined as rapidly progressive deterioration of renal function. If it is also accompanied by an active urinary sediment, it is inferred that one of these may be taking place: a rapidly progressive glomerulonephritis, a thrombotic microangiopathy, an atheroembolic renal disease or an interstitial nephritis. In most cases the speed with which the treatment is initiated impacts on its result, which often requires that it is done empirically. However, as the therapy used is not innocuous, we must maximize diagnostic measures to define the etiology; this case is an example of this.References
Brummer E, Castaneda E, Restrepo A. Paracoccidioidomycosis: an update. Clin Microbiol Rev. 1993;6(2):89-117.
Casella FJ, Allon M. The kidney in sarcoidosis. J Am Soc Nephrol. 1993;3(9):1555-62.
Jennette JC. Rapidly progressive crescentic glomerulonephritis. Kidney Int. 2003;63(3):1164-77.
Praga M, González E. Acute interstitial nephritis. Kidney Int. 2010;77(11):956-61.
Restrepo A, Tobon AM, Agudelo CA. Paracoccidioidomycosis. En: Hospenthal DR, Rinaldi MG, eds. Diagnosis and treatment of human Mycoses. Totowa, NJ: Humana Press, 2008, p. 331.