Repeat renal biopsy in a girl with tubulointerstitial nephritis and uveitis syndrome

Pediatr Nephrol. 2001 Nov;16(11):885-7. doi: 10.1007/s004670100697.

Abstract

A Japanese girl aged 8 years who presented with a 2-month history of uveitis subsequently developed tubulointerstitial nephritis. A percutaneous renal biopsy revealed massive interstitial mononuclear cell infiltrates consisting of CD4-positive T cells. Despite administration of topical corticosteroids, the ocular symptoms persisted. Systemic corticosteroid therapy dramatically reduced the ocular symptoms and urinary beta2-microglobulin (beta 2MG) concentration. However, reducing the prednisolone dosage induced recurrence of uveitis associated with increased levels of urinary beta 2MG. The CD4-positive T cell infiltration persisted in the second renal biopsy performed 6 months after the first renal biopsy. These observations suggest that the interstitial cell infiltration persists for a relatively long time in a proportion of patients with tubulointerstitial nephritis and uveitis syndrome (TINU). Although the renal outcome of TINU has been reported to be favorable, prolonged interstitial cell infiltration may affect long-term renal outcome. Selected patients with TINU should be followed with close observation.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Biopsy
  • CD4-Positive T-Lymphocytes / pathology
  • Child
  • Female
  • Humans
  • Kidney / pathology*
  • Nephritis, Interstitial / drug therapy
  • Nephritis, Interstitial / pathology*
  • Reoperation
  • Syndrome
  • Uveitis / drug therapy
  • Uveitis / pathology*
  • Uveitis / urine
  • beta 2-Microglobulin / urine

Substances

  • Adrenal Cortex Hormones
  • beta 2-Microglobulin