Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy.
10.3345/kjp.2016.59.11.S99
- Author:
Ji Eun KIM
1
;
Se Jin PARK
;
Ji Young OH
;
Hyeon Joo JEONG
;
Ji Hong KIM
;
Jae Il SHIN
Author Information
1. Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. shinji@yuhs.ac
- Publication Type:Case Report
- Keywords:
Tubulointerstitial nephritis and uveitis;
Steroids;
Azathioprine
- MeSH:
Acute Kidney Injury;
Azathioprine*;
Biopsy;
Child*;
Diagnosis;
Diagnosis, Differential;
Follow-Up Studies;
Humans;
Male*;
Nephritis, Interstitial*;
Panuveitis;
Prednisolone;
Rare Diseases;
Recurrence;
Renal Insufficiency;
Steroids;
Uveitis*
- From:Korean Journal of Pediatrics
2016;59(Suppl 1):S99-S102
- CountryRepublic of Korea
- Language:English
-
Abstract:
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.
