Original articleImmunomodulatory therapy for chronic tubulointerstitial nephritis–associated uveitis
Section snippets
Patients and methods
The charts of all patients with tubulointerstitial nephritis and uveitis seen at the Massachusetts Eye and Ear Infirmary between 1996 and 1999 were reviewed. Information regarding age, sex, race, renal biopsy results, interval between kidney and eye involvement, type of uveitis, topical and oral treatment for uveitis, visual acuity at presentation and at last examination, complications, and follow-up were analyzed.
Results
Six patients with tubulointerstitial nephritis and uveitis were seen at the Massachusetts Eye and Ear Infirmary and were included in the study. There were three men and three women; all were white. The mean (±SD) age was 24.3 (±16.5) years, with a range of 13 to 49 years. All patients presented with acute febrile illness associated with fatigue, malaise, and nausea. Laboratory investigations revealed high creatinine levels, proteinuria, and anemia. The diagnosis of tubulointerstitial nephritis
Case 1
: In 1997, a 13-year-old girl developed an acute febrile illness associated with fatigue, thirst, and nausea. Laboratory tests showed high creatinine levels and proteinuria, and clinical examination confirmed enlarged kidneys. Renal biopsy revealed tubulointerstitial nephritis.
Normalization of the renal function was achieved quickly with systemic prednisone therapy. Four months later and while the patient was still on prednisone, she complained of pain, redness, and photophobia in both eyes. An
Discussion
Acute interstitial nephritis has a variety of etiologies, including drugs (antibiotics, diuretics, nonsteroidal antiinflammatory drugs), infections (viruses, group A streptococcus, pneumococcus, Yersinia pseudotuberculosis, salmonella, legionella, mycobacteria, toxoplasma, leptospira) and immunologic disorders (sarcoidosis, Sjögren syndrome, scleroderma, systemic lupus, Still disease). Acute interstitial nephritis of unknown etiology is labeled idiopathic.2, 13, 22 The typical histologic
References (31)
- et al.
Acute eosinophilic interstitial nephritis and retinal failure with bone marrow-lymph node granulomas and anterior uveitis. A new syndrome
Am J Med
(1975) - et al.
Acute tubulointerstitial nephritis and uveitis with immune antineutrophil cytoplasmic antibody
Am J Kidney Dis
(1996) Bilateral anterior uveitis and interstitial nephritis
Am J Ophthalmol
(1988)- et al.
Idiopathic acute interstitial nephritis and uveitis in the adult
Am J Nephrol
(1986) - et al.
Idiopathic acute interstitial nephritis associated with anterior uveitis in adults
Clin Nephrol
(1989) - et al.
Acute tubulointerstitial nephritis and uveitis syndrome in the elderly
Br J Ophthalmol
(1990) - et al.
Acute tubulointerstitial nephritis and uveitis syndrome (TINU syndrome). Occurrence of uveitis after stopping steroids
Nephrol Dial Transplant
(1998) - et al.
Acute tubulointerstitial nephritis and uveitis
Acta Paediatr Belg
(1980) - et al.
Tubulointerstitial nephritis and uveitis
Ophthalmology
(1992) - et al.
A syndrome of acute interstitial nephritis and anterior uveitis
Pediatr Nephrol
(1993)
Primary tubulointerstitial nephritis and uveitis syndrome
Aust N Z J Ophthalmol
Acute interstitial nephritis in childrena report of 13 cases and review of the literature
Pediatrics
Acute tubulointerstitial nephritis and uveitis and favorable outcomes after five months of continuous peritoneal dialyses (CAPD)
Neth J Med
Cited by (77)
Classification Criteria for Tubulointerstitial Nephritis With Uveitis Syndrome
2021, American Journal of OphthalmologyA case of tubulointerstitial nephritis and uveitis syndrome complicated with Fanconi syndrome and literature review
2024, Chinese Journal of NephrologyTubulointerstitial Nephritis and Uveitis Syndrome in Pediatric Patients
2023, Ocular Immunology and Inflammation