Tubular Interstitial Nephritis Secondary to Herbal Consumption: Case Report and Literature Review

Abstract

Acute tubular interstitial nephritis is a form of immune-mediated renal injury characterized by infiltration of immune cells in the renal tubulointerstitium, leading to oliguric or non-oliguric acute kidney injury. It manifests with systemic arterial hypertension, foamy urine, and sometimes with secondary anemia if there is progression to chronic renal disease. The diagnosis of certainty is made by biopsy, the initial treatment consists of identifying and removing the triggering agent to avoid further exposure to toxins, management of the acute renal lesion and in some cases, it may be decided to start corticosteroids to avoid progression to end-stage chronic kidney disease. We present the case of a 24-year-old female patient with a history of consumption of unspecified herbal medicine for aesthetic purposes 3 years prior to our evaluation, who debuted with hypertensive emergency manifested by hypertensive retinopathy, hypertensive renal vasculopathy and tubulointerstitial nephritis, successfully treated with the withdrawal of the aggressor agent, angiotensin converting enzyme inhibitors, nitrates and corticosteroids. After 6 months of follow-up, the patient is asymptomatic and with total recovery of the renal disease documented by normal creatinine in laboratory tests.