# A Case of Steroid-Responsive Acute Tubular Injury of Unknown Trigger: A Case Report

## TL;DR

A young man with unexplained kidney damage showed improvement with steroid treatment, suggesting an immune-related cause.

## Contribution

This case report highlights steroid responsiveness in a rare, idiopathic form of acute tubular necrosis.

## Key findings

- The patient's acute tubular necrosis did not respond to standard supportive care but improved with steroids.
- Multiple kidney biopsies confirmed recurrent ATN with no identifiable cause.
- The response to steroids suggests an autoimmune or inflammatory component in this case of ATN.

## Abstract

Acute tubular necrosis (ATN) is a serious medical condition characterized by the rapid destruction of renal tubular epithelial cells, resulting in acute kidney injury, given its multifactorial etiologies, which can include nephrotoxic agents, ischemic insults, hypovolemia, and sepsis. We report the case of a young male patient who presented with recurrent worsening kidney function with bland sediment that was confirmed with multiple kidney biopsies as recurrent attacks of ATN of unclear etiology, which did not respond to supportive measures but did respond to steroids.