• Yohei Suehiro, Hiroyuki Ueda, Saya Motohashi, Shiko Honma, Hiroki Nobayashi, Risa Ueda, Yukio Maruyama, Tetsuya Horino, Yoji Ogasawara, Kensuke Joh, Nobuo Tsuboi, and Takashi Yokoo.
• Division of Nephrology and Hypertension, the Jikei University School of Medicine, Japan.
• Intern. Med. 2023 Jun 15; 62 (12): 179518001795-1800.

AbstractTuberculosis is a common etiology of granulomatous interstitial nephritis (GIN). However, the absence of evidence of lung involvement and lack of mycobacterial isolation in cultures make the etiological diagnosis and treatment decision challenging. We herein report a 46-year-old man with severe renal failure, a persistent fever, and a history of lymphoma. A renal biopsy exhibited GIN. Despite no evidence of tuberculosis except for a positive interferon-gamma release assay (IGRA), the patient was successfully treated with anti-tuberculosis drugs. Our case suggests that anti-tuberculosis therapy should be considered for patients with IGRA-positive GIN after excluding other etiologies.

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