AIIMS November 2011 – MCQ 56

Which of the following does not present with eosinophilia and acute renal failure?
A. Drug induced interstitial nephritis
B. Atheroembolic phenomena
C. Contrast nephropathy
D. PAN

Correct answer : C. Contrast nephropathy (All except contrast nephropathy are mentioned as producing eosinophilia.)

Ref: Harrison, 18th ed, Chapter 279 – Acute Kidney Injury

“Peripheral eosinophilia can accompany interstitial nephritis, atheroembolic disease, polyarteritis nodosa, and Churg-Strauss vasculitis.”

“While many of the ischemic and toxic causes of AKI previously described result in tubulointerstitial disease, many drugs are also associated with the development of an allergic response characterized by an inflammatory infiltrate and often peripheral and urinary eosinophilia.”

“Contrast nephropathy is thought to occur from a combination of factors, including (1) hypoxia in the renal outer medulla due to perturbations in renal microcirculation and occlusion of small vessels; (2) cytotoxic damage to the tubules directly or via the generation of oxygen free radicals, especially since the concentration of the agent within the tubule is markedly increased; and (3) transient tubule obstruction with precipitated contrast material.”