Abstract
Sera from nine patients with drug-induced acute interstitial nephritis were assayed for circulating anti-tubular basement membrane (anti-TBM) antibodies by an indirect immunofluorescent technique, and IgE levels by radioimmunosorbent. Circulating anti-TBM antibodies were detected in two of nine sera studied; titers of antibody were unrelated to the activity of the disease. Passive transfer of anti-TBM antibody failed to reproduce the disease in animals. Immunofluorescence studies of five renal biopsies showed the following patterns: linear deposits of IgG (one biopsy) and C3 (two biopsies) along TBM, IgG plasma-bearing cells in the interstitium (one biopsy); and patchy interstitial deposits of fibrinogen and IgG (one biopsy). IgE levels were increased in three of seven specimens studies; sequential assays on a single patient showed a rise during the acute phase of the illness. These observations suggest the possibility of heterogenous mechanisms in the induction of this form of renal disease.