The importance of a histology-based diagnosis of interstitial nephropathy in two patients with renal insufficiency.

Case 1 A 68-year-old Belgian woman was referred in November 1997 forevaluation of renal failure (serum creatinine 2.8 mg/dl). Herpast medical history included hypothyroidism treated by L-thyroxinsince 1992, resection of an endometrial polyp in 1996 and chronicconstipation for many years. Her current treatment includedvarious laxatives (lactulose, bisacodyl) and anxiolytics (flupentixol).She acknowledged the previous intake of phenacetin and dexfenfluramine,but denied that of Chinese herbs or any other herbal phytotherapy. View larger version (147K): [in this window] [in a new window]   Fig. 1.  Extensive cortical and medullary hypocellular interstitial fibrosis with tubular atrophy (case 1). Few ischaemic glomeruli are still visible in the deep cortex. Intimal fibrous thickening and mucoid fibrous hyperplasia of interlobular and arcuate arteries, respectively. HE x40.   On admission, the patient was thin: body weight 49 kg, height1.59 m; her blood pressure was 200/90