Korean J Pediatr.  2016 Nov;59(Suppl 1):S99-S102. 10.3345/kjp.2016.59.11.S99.

Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy

• Kim JE
• Park SJ
• Oh JY
• Jeong HJ
• Kim JH
• Shin JI

• KMID: 2362267
• DOI: http://doi.org/10.3345/kjp.2016.59.11.S99

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.

Keyword

Tubulointerstitial nephritis and uveitis; Steroids; Azathioprine

MeSH Terms

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*
Azathioprine
Prednisolone
Steroids