When Kidney Mirrors the Eye: Tubulointerstitial Nephritis and Uveitis Syndrome - Case Report

Abstract

Tubulointerstitial nephritis and uveitis syndrome is an underdiagnosed condition, characterized by the involvement of the kidney and the eye that affects mostly young people. Its pathophysiology remains poorly understood; however, pediatric morbidity is mostly associated with recurrences of uveitis. This article aimed to describe two clinical cases of tubulointerstitial nephritis and uveitis syndrome, with distinct presentations and clinical courses, illustrative of the diversity of this entity. Case1: An 11-year-old male was admitted to the hospital due to a non-oliguric acute kidney injury. A 24-hour urine examination revealed a tubular lesion, and two months later, he was diagnosed with bilateral anterior uveitis. He was started on steroids, with a favorable response. After six weeks, renal function and urine parameters returned to normal. Case 2: A 12-year-old male was admitted to the hospital with complaints of bilateral red eyes. He was diagnosed with bilateral anterior uveitis and treated with topical steroids with transient improvement. At the same time, the clinical investigation detected a tubular lesion. Four months later, due to a uveitis hypertensive flare with macular edema, methotrexate was added to his treatment, which had a favorable response. Six months later, the urinary abnormalities disappeared. The tubulointerstitial nephritis and uveitis syndrome should be actively searched in the presence of tubular renal abnormalities or uveitis in pediatric patients.