Tubulointerstitial nephritis and uveitis syndrome - a case report

Introduction. Tubulointerstitial nephritis and uveitis syndrome is a rare oculo-renal disease characterized by the presence of bilateral, anterior uveitis and tubulointerstitial nephritis. The pathogenesis of this disease is still not completely clear. It is associated with prior drug use, infections and autoimmune diseases. The involvement of the cellular and humoral immune responses and genetic predisposition to the development of this syndrome are frequently mentioned in the literature. In a certain number of cases, despite extensive diagnostics, the cause remains unknown (idiopathic tubulointerstitial nephritis and uveitis syndrome). Case Report. A fifteen-year-old female patient was admitted to the Department of Nephrology due to complaints of headache in the temples that occasionally occurred in the previous months. Three days before admission, the patient presented with symptoms of upper respiratory tract infection and subfebrile temperature (to 37.8o C). Laboratory test results revealed the development of acute tubulointerstitial nephritis, and in the fifth week of the disease, bilateral anterior uveitis was detected. The diagnosis was confirmed by percutaneous kidney biopsy. Systemic and local corticosteroid therapy was introduced, and after a month it resulted in gradual normalization of kidney function, proteinuria reduction and withdrawal of the ophthalmic symptoms. Conclusion. Due to the fact that kidney damage is often self-limited and that uveitis tends to be recurrent, there is a high probability of untimely diagnosis. Early recognition, detection of potential causes and initiation of treatment, are crucial in the prevention of disease progression and development of chronic sequelae such as chronic renal failure and chronic uveitis.