PMC9193386_01
Creatinine trend. ATIN, Acute tubulointerstitial nephritis.
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F1
Two days later, he developed pitting pedal edema, reduced urine output (250 ml/day) and serum creatinine increased up to 5.8 mg/dL as shown in Table 1 and creatinine trend shown in Figure 1.
Hematoxylin and eosin (H&E) stain. (A) Low power- diffuse cellular infiltrate within the interstitium with inflammatory cells including eosinophils and lymphocytes. (B) High power- the tissue sample shows the presence of inflammatory cell infiltrate within the tubular wall (arrowhead) and numerous eosinophils in the interstitium (arrow).
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F2
Given concern for acute tubulointerstitial nephritis, vancomycin was immediately stopped, kidney biopsy was obtained which confirmed the presence of eosinophils in the interstitium and interstitial cells within the tubules as shown in Figure 2.