Tubulointerstitial nephritis and uveitis with bilateral multifocal choroiditis.
OBJECTIVE
To report a case of bilateral multifocal choroiditis secondary to tubulointerstitial nephritis and uveitis.


METHODS
Case report. A 16-year-old women with an 11-month history of tubulointerstitial nephritis and uveitis and bilateral anterior uveitis developed bilateral multifocal choroiditis. After initial unsuccessful treatment with topical steroids, treatment was augmented by a 2-week course of systemic prednisone.


RESULTS
Intensive steroid treatment resulted in steroid-induced glaucoma, which required bilateral trabeculectomies, but the uveitis became inactive. Two years after uveitis onset, bilateral intraocular pressure was normal, there were occasional (12+) anterior chamber cells, and inactive depigmented chorioretinal lesions on topical steroid drops. See also pp. 764-768, 798-799.


CONCLUSIONS
Tubulointerstitial nephritis and uveitis usually involves only the anterior uvea, although a few cases of posterior uveitis have been described. This article reports a case of multifocal choroiditis associated with tubulointerstitial nephritis and uveitis. It is important for ophthalmologists to be aware of possible posterior uveal involvement in tubulointerstitial nephritis and uveitis so they can choose the most appropriate immunosuppressive therapy for the uveitis.
Royal College of Surgeons of Canada, University of Toronto, Toronto, Canada. larissa-myron-dzuynsky@sympatico.ca
L
L
Derzko-Dzulynsky
T
T
Rabinovitch
D000293:Adolescent; D002833:Choroiditis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005901:Glaucoma / Q000139:chemically induced / Q000601:surgery; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure; D009395:Nephritis, Interstitial / Q000150:complications* / Q000188:drug therapy; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D014130:Trabeculectomy; D014606:Uveitis, Anterior / Q000150:complications* / Q000188:drug therapy; D015866:Uveitis, Posterior / Q000150:complications* / Q000188:drug therapy
D005938:Glucocorticoids; D011241:Prednisone