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October 10, 1977

Acute Interstitial Nephritis

JAMA. 1977;238(15):1628-1629. doi:10.1001/jama.1977.03280160022006

To the Editor.—  The entity of idiopathic acute interstitial nephritis was proposed five years ago.1 We present another example of this process, again devoid of the usual inciting agents— drugs or infection.

Report of a Case. —  One day after inhalation of "polyamide epoxy" high gloss paint fumes, a 20-year-old man had gross hematuria. His BUN level was then 15 mg/dl. There was no family history of hematuria.2 Within five days he was uremic. His blood pressure was 120/70 mm Hg; he weighed 55 kg. Results of the physical examination were unremarkable. There was no uveitis.3 Blood count was normal with 3% eosinophils. His BUN level was 66 mg/dl and creatinine level, 5.2 mg/dl. Urine sediment contained hundreds of erythrocytes and ten WBCs per high-power field. Urine sodium level was 23 mEq/liter, and urine osmolality was 357 mOsm/kg. Urine protein excretion was 1.0 g/24 hr; antistreptolysin O