94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
CASE REPORT article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1465783
The Unexpected Diagnosis of Karyomegalic Interstitial Nephritis in a Presumed Case of Mesoamerican Nephropathy: A Case Report
Provisionally accepted- 1 Westchester Medical Center Health Network, Valhalla, United States
- 2 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
BackgroundChronic kidney disease of unknown etiology (CKDu) is a form of chronic kidney disease commonly found in certain rural populations globally. This condition is characterized by chronic tubulointerstitial nephropathy, yet it lacks specific signature lesions and is believed to have a multifactorial etiology, often associated with environmental toxins. Karyomegalic Interstitial Nephritis (KIN), although a rare form of chronic interstitial nephropathy leading to end-stage kidney disease, is not classified under CKDu.Case PresentationIn this case report, we explore the diagnostic journey of a 40-year-old male farmer from Guatemala. He presented with headache, fever, and facial pain, but laboratory tests revealed significant kidney impairment and liver dysfunction. The pivotal point in his diagnostic workup was a kidney biopsy, which showed severe chronic tubulointerstitial scarring and enlarged, hyperchromatic nuclei in the tubular epithelial cells, confirming KIN. This diagnosis marked a departure from the initial suspicion of Mesoamerican Nephropathy (MEN).ConclusionsThis case underscores the critical need for a comprehensive evaluation in atypical presentations of chronic kidney disease, particularly emphasizing the importance of being vigilant for KIN in areas where MEN is commonly diagnosed.
Keywords: Karyomegalic interstitial nephritis, Mesoamerican nephropathy, Chronic kidney disease of unknown etiology, Tubulointerstitial nephropathy, Kidney biopsy diagnosis
Received: 16 Jul 2024; Accepted: 12 Feb 2025.
Copyright: © 2025 Kwon, Griffiths and DiFranza. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lawrence Kwon, Westchester Medical Center Health Network, Valhalla, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.