PT  - JOURNAL ARTICLE
AU  - C Shimura
AU  - T Saraya
AU  - H Wada
AU  - S Takata
AU  - S Mikura
AU  - T Yasutake
AU  - J Kato
AU  - A Kato
AU  - M Yamamoto
AU  - M Watanabe
AU  - T Yokoyama
AU  - D Kurai
AU  - H Ishii
AU  - M Aoshima
AU  - A Yamada
AU  - H Goto
TI  - Pathological evidence of rhabdomyolysis-induced acute tubulointerstitial nephritis accompanying <em>Legionella pneumophila</em> pneumonia
AID  - 10.1136/jcp.2008.057000
DP  - 2008 Sep 01
TA  - Journal of Clinical Pathology
PG  - 1062--1063
VI  - 61
IP  - 9
4099  - http://jcp.bmj.com/content/61/9/1062.short
4100  - http://jcp.bmj.com/content/61/9/1062.full
SO  - J Clin Pathol2008 Sep 01; 61
AB  - A case of Legionella pneumophila pneumonia with rhabdomyolysis-induced acute tubulointerstitial nephritis (ATIN) and prolonged renal dysfunction is presented. The patient was a 54-year-old man, admitted with high-grade fever, ataxia and muscle dysfunction; chest roentgenogram showed multilobular infiltrations. L pneumophila was detected in his sputum and urine, by PCR and by culture, and L pneumophila pneumonia was diagnosed. Despite antimicrobial treatment, he developed renal failure and rhabdomyolysis. Renal biopsy showed the presence of myoglobin casts that occluded the distal tubuli and tubulointerstitial nephritis, leading to the diagnosis of rhabdomyolysis-induced ATIN. Renal function subsequently normalised, and he was discharged. This is believed to be the first pathological evidence of involvement of rhabdomyolysis in legionellosis-associated ATIN.