Repeat renal biopsy in a girl with tubulointerstitial nephritis and uveitis syndrome.
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.
Tanaka
H
H
Department of Pediatrics, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan. hirotana@cc.hirosaki-u.ac.jp
Suzuki
K
K
Nakahata
T
T
Tateyama
T
T
Waga
S
S
Ito
E
E
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001706:Biopsy; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D009395:Nephritis, Interstitial / Q000188:drug therapy / Q000473:pathology*; D012086:Reoperation; D013577:Syndrome; D014605:Uveitis / Q000188:drug therapy / Q000473:pathology* / Q000652:urine; D001613:beta 2-Microglobulin / Q000652:urine
D000305:Adrenal Cortex Hormones; D001613:beta 2-Microglobulin