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Causes of Acute Tubulointerstitial Nephritis

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Cause	Examples
Medications*
Antibiotics	Beta-lactam antibiotics (the most common cause) CiprofloxacinCiprofloxacin EthambutolEthambutol IndinavirIndinavir IsoniazidIsoniazid Macrolides MinocyclineMinocycline RifampinRifampin TetracyclineTetracycline Trimethoprim/sulfamethoxazoleTrimethoprim/sulfamethoxazole VancomycinVancomycin
Antiseizure medications	CarbamazepineCarbamazepine PhenobarbitalPhenobarbital PhenytoinPhenytoin Valproate
Diuretics	BumetanideBumetanide FurosemideFurosemide Thiazides TriamtereneTriamterene
Nonsteroidal anti-inflammatory drugs (NSAIDs)	DiclofenacDiclofenac Fenoprofen Fenoprofen IbuprofenIbuprofen IndomethacinIndomethacin NaproxenNaproxen
Other	AllopurinolAllopurinol Aristolochic acid† CaptoprilCaptopril CimetidineCimetidine Interferon alfa LansoprazoleLansoprazole MesalamineMesalamine OmeprazoleOmeprazole Ranitidine
Metabolic disorders
Hyperoxalaturia	Ethylene glycol poisoning
Hyperuricosuria	Tumor lysis syndrome
Renal parenchymal infection
Bacterial	Brucella species (brucellosis) Corynebacterium diphtheriae Legionella species (Legionella infections) Leptospira species (leptospirosis) Mycobacterium species Mycoplasma species Rickettsia species Salmonella species Staphylococci Streptococci Treponema pallidum (syphilis) Yersinia species
Fungal	Candida species
Parasitic	Toxoplasma gondii (toxoplasmosis)
Viral	Cytomegalovirus Epstein-Barr virus Hantavirus Hepatitis C virus (acute and chronic) HIV Mumps Polyomavirus
Other conditions
Idiopathic without and with uveitis	—
Immunologic	Anti-tubular basement membrane (anti-TBM) antibody-associated interstitial nephritis Cryoglobulinemia Granulomatosis with polyangiitis Idiopathic hypocomplementemic interstitial nephritis IgA nephropathy IgG4-related tubulointerstitial nephritis‡ Renal transplant rejection Sarcoidosis Sjögren syndrome Systemic lupus erythematosus (SLE); rare
Neoplastic	Lymphoma Myeloma
* Most common causative medications are listed; > 120 medications are implicated.
† Contained in some medicinal herbs used in traditional Chinese medicine.
‡ Yamaguchi Y, Kanetsuna Y, Honda K, et al: Characteristic tubulointerstitial nephritis in IgG4-related disease. Hum Pathol 43(4):536-549, 2012. doi: 10.1016/j.humpath.2011.06.002