title: Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy.
abstract: Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.
authors.affiliation: Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Daewoo General Hospital, Ajou University School of Medicine, Geoje, Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Oh
authors.affiliation: Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyeon Joo
authors.initials: HJ
authors.lastname: Jeong
authors.affiliation: Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
keywords: Azathioprine; Steroids; Tubulointerstitial nephritis and uveitis