title: TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME WITH A PRIMARY PRESENTATION OF ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY.
abstract: OBJECTIVE
  To report a case of tubulointerstitial nephritis and uveitis syndrome with a primary presentation of acute posterior multifocal placoid pigment epitheliopathy after use of lamotrigine.
  
  
  METHODS
  Retrospective case report with ultra-widefield fundus imaging, optical coherence tomography, and fluorescein angiography.
  
  
  RESULTS
  A 19-year-old woman presented with decreased visual acuity and acute renal failure after starting lamotrigine. Her examination demonstrated 1+ anterior chamber cell and numerous white deep retinal plaque-like lesions predominantly in the macula in both eyes. After extensive ophthalmic and systemic evaluation, the patient was diagnosed with tubulointerstitial nephritis and uveitis syndrome with a primary presentation of acute posterior multifocal placoid pigment epitheliopathy. She had excellent visual recovery with topical and systemic steroids.
  
  
  CONCLUSIONS
  Acute posterior multifocal placoid pigment epitheliopathy is a rare but important clinical presentation of tubulointerstitial nephritis and uveitis syndrome. Oral corticosteroid treatment can be considered for tubulointerstitial nephritis but is generally not necessary for acute posterior multifocal placoid pigment epitheliopathy.
authors.affiliation: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Lee
authors.forename: Sumit
authors.initials: S
authors.lastname: Sharma
authors.forename: Tamer H
authors.initials: TH
authors.lastname: Mahmoud
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D012164:Retinal Diseases / Q000139:chemically induced* / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D014227:Triazines / Q000009:adverse effects*; D014605:Uveitis / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine