A Case of Cocaine-Induced Acute Interstitial Nephritis

(A) Hematoxylin and eosin–stained section shows interstitial inflammatory cell infiltrate in the cortex associated with edema and tubular injury. The 2 glomeruli show minor abnormalities. (B) Interlobular artery shows prominence and bulging of the endothelium into the lumen, but no vasculitis. (C, D, E) Interstitial edema and diffuse interstitial inflammatory cell infiltration with eosinophils (C, inset), tubules show degeneration with sloughed cells (D, E) and leukocytes (D) in the lumen. (F) Reactive tubule with cellular debris and some detached epithelial cells (arrows) in the lumen. Arrowhead points to an eosinophil with its characteristic vivid eosinophilic granular cytoplasm (original magnification: [A] ×100, [B to E] ×200, [F, inset in C] ×400).