title: Tubulointerstitial nephritis and uveitis syndrome in children: a prospective multicenter study.
abstract: OBJECTIVE
  To evaluate the occurrence and characteristics of uveitis related to tubulointerstitial nephritis (TIN) in children.
  
  
  METHODS
  Prospective, observational, multicenter, partly placebo-controlled treatment trial.
  
  
  METHODS
  Nineteen children with a biopsy-proven TIN.
  
  
  METHODS
  Patients were treated with prednisone or followed without treatment. In addition to the nephrologic evaluations, the prospective follow-up included structured ophthalmological examinations at the onset of TIN and at 3 and 6 months after the diagnosis.
  
  
  METHODS
  Occurrence, clinical features, and outcome of uveitis.
  
  
  RESULTS
  Some 84% (16/19) of the patients had uveitis, 83% (5/6) in the nontreatment group and 82% (9/11) in the prednisone-treated group. The remaining 2 patients, originally in the nontreatment group, were switched to the prednisone group after 2 weeks. Both of them developed uveitis. Altogether, 3 patients developed uveitis during prednisone treatment and 2 patients showed worsening of uveitis despite the systemic corticosteroid. Some 50% (8/16) of the patients with uveitis presented with no ocular symptoms; 88% (14/16) of the patients had a chronic course of uveitis. Two patients were diagnosed with uveitis before nephritis; nephritis and uveitis were diagnosed within 1 week from each other in 7 patients, and uveitis developed 1 to 6 months after the diagnosis of TIN in 7 patients.
  
  
  CONCLUSIONS
  There was no statistically significant difference in the occurrence of uveitis in patients with TIN in the prednisone and nontreatment groups. In this study, the occurrence of uveitis associated with TIN was considerably higher than previously reported. Uveitis related to TIN may develop late and is often asymptomatic. The ophthalmological follow-up of all patients with TIN is warranted for at least 12 months starting with 3-month intervals.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any material discussed in this article.
authors.affiliation: Department of Ophthalmology, Oulu University Hospital, Oulu, Finland. ville.saarela@oulu.fi
authors.forename: Ville
authors.initials: V
authors.lastname: Saarela
authors.forename: Matti
authors.initials: M
authors.lastname: Nuutinen
authors.forename: Marja
authors.initials: M
authors.lastname: Ala-Houhala
authors.forename: Pekka
authors.initials: P
authors.lastname: Arikoski
authors.forename: Kai
authors.initials: K
authors.lastname: Rönnholm
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009395:Nephritis, Interstitial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids; D011241:Prednisone