Glycosuria and Acute Kidney Injury: A Rare Presentation of Acute Interstitial Nephritis

Abstract Acute Interstitial Nephritis (AIN) is often induced by drugs and is a common cause of acute kidney injury. Clinically diagnosing AIN can often be challenging as these signs and symptoms rarely present in concert. The inflammatory pathology of AIN leads to renal tubule dysregulation which can be clinically observed as glycosuria, eosinophilia, leukocytes or white blood cell casts and proteinuria. We present a case of an otherwise healthy woman in her 30s with AIN presenting with acute kidney injury and glycosuria without pyuria. This patient had an atypical presentation of AIN that lacked classical diagnostic lab features and has been rarely reported. She had profound glycosuria in setting of normoglycemia, which resolved following a course of corticosteroids. Glycosuria was most likely due to proximal tubule damage from AIN. This case supports previous hypotheses that drug-induced AIN can cause proximal tubule dysfunction resulting in glycosuria in the absence of other identifiable proximal tubule dysregulations. We hypothesize resolution of AIN involves the repair and restoration of SGLT function.