육아종성 세관사이질신염으로 확인된 크론병

• Published in: The Korean journal of medicine Vol. 97; no. 3; pp. 186 - 190
• Main Authors: 한정석, Jung Suk Han, 최범순, Bum Soon Choi, 박철휘, Cheol Whee Park, 최영진, Yeong Jin Choi, 양철우, Chul Woo Yang, 이한희, Han Hee Lee, 반태현, Tae Hyun Ban
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.06.2022
• Subjects: Crohn disease; Inflammatory bowel diseases; interstitial; Kidney diseases; Nephritis; 내과학; 사이질신염; 신장병; 염증성장질환; 크론병
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2022.97.3.186

크론병의 장관 외 발현 중 육아종성 세관사이질신염은 매우 드문 사례이다. 아직 정립된 치료는 없으나, 크론병 환자에서 신기능의 악화를 보인다면 크론병에 의한 세관사이질신염을 의심하여야 하며, 빠른 진단과 치료를 하여 환자의 신기능의 악화를 억제하여야 한다. Crohn’s disease is usually diagnosed according to intestinal symptoms, but extra-intestinal manifestations are important in approximately one-third of cases. Although several extra-intestinal symptoms associated with various organs have been reported, renal involvement is uncommon in patients with Crohn’s disease. Tubulointerstitial nephritis in a patient with Crohn’s disease is usually caused by infection, sarcoidosis, or medications. However, primary tubulointerstitial nephritis caused by Crohn’s disease alone is extremely rare. A 19-year-old male patient was referred to our hospital because of an increase in serum creatinine level. He underwent a kidney biopsy with renal insufficiency. Renal histological findings revealed granulomatous tubulointerstitial nephritis. Thereafter, a colonoscopy was performed with suspicion of Crohn’s disease. Ultimately, he was diagnosed with granulomatous tubulointerstitial nephritis based on Crohn’s disease. The patient had improved gastrointestinal symptoms after the last treatment. This case report presents a rare case of primary tubulointerstitial nephritis caused by Crohn’s disease. (Korean J Med 2022;97:186-190)