Interstitial Nephritis Presenting as Bilateral Renal Masses in a Pediatric Patient with Crohn’s Disease

M Bouchard,Eleny Romanos-Sirakis

doi:10.36013/jimsa.v1i1.15

Abstract

We present the case of a teenage boy with Crohn’s disease treated with adalimumab who presented with discrete renal masses, found while undergoing evaluation for elevated creatinine and hypocalcemia. The MRI result, as well as the potential increased risk of malignancy in patients treated with TNF-blockers, both contributed to primary concerns of malignancy in this case. Pathology was consistent, however, with IN and not malignancy. The radiographic presentation of the IN in this case was very unusual, as IN can present as a striated nephrogram on imaging, but has not been described as discrete masses. We are not aware of any other cases of IN reported appearing this way on imaging.

Highlights

When primary malignant renal tumors occur during the 2nd decade of life, they are most commonly renal cell carcinomas and less frequently, Wilms tumors [1]
We present the case of a teenage boy with Crohn’s disease treated with adalimumab who presented with discrete renal masses, found while undergoing evaluation for elevated creatinine (1.35 mg/dL) and hypocalcemia (5.3 mg/dL)
The MRI result, as well as the potential increased risk of malignancy in patients treated with Tumor necrosis factor (TNF)-blockers, both contributed to primary concerns of malignancy in this case [2]