Immunomodulatory therapy for chronic tubulointerstitial nephritis-associated uveitis.
OBJECTIVE
To describe the clinical course and treatment with immunomodulatory agents in patients with tubulointerstitial nephritis and uveitis syndrome.


METHODS
Retrospective analysis of the charts of six patients with tubulointerstitial nephritis and uveitis syndrome.


RESULTS
The mean (+/-SD) age was 24.3 (+/-16.5) years, range 13 to 49 years. Four patients were children, and two were adults. Three were men, and three were women. Five of the six patients had anterior uveitis, and one had panuveitis. All patients had several relapses despite treatment with topical, regional, and oral steroids and methotrexate in one case. The introduction or modification of immunosuppressants (methotrexate, azathioprine, or cyclosporin A) achieved control of the uveitis and prevented relapses over a mean (+/-SD) follow-up period of 19.66 (+/-10.01) months, range 6 to 34 months. No treatment-related side effects were observed.


CONCLUSIONS
Tubulointerstitial nephritis and uveitis syndrome is a distinct disease entity in which the nephritis typically resolves, but the uveitis often becomes chronic and is treatment resistant. Immunomodulatory agents can achieve control of the inflammation and prevent relapses.
Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
N
N
Gion
P
P
Stavrou
C S
CS
Foster
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000150:complications / Q000188:drug therapy*; D015864:Panuveitis / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D055502:Secondary Prevention; D014606:Uveitis, Anterior / Q000150:complications / Q000188:drug therapy*; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D008727:Methotrexate