Acute renal failure associated with Yersinia pseudotuberculosis infection

Since 1987, we have experienced 11 children with acute renal failure (ARF) associated with Yersinia pseudotuberculosis (YP) infection. The illness began with the sudden onset of high fever, skin rash and gastrointestinal symptoms. Later in the course, periungual desquamation developed, mimicking Kawasaki disease. Elevated erythrocyte sedimentation rate, C-reactive protein and thrombocytosis were noticeable, and mild degrees of proteinuria, glycosuria and sterile pyuria were common. ARF, which typically developed about 1-3 weeks after the onset of fever, underwent a benign course with complete recovery. The renal biopsies mainly revealed findings of acute tubulointerstitial nephritis. YP should be considered as one of the causes of acute tubulointerstitial nephritis causing ARF, especially in children.