An Adult Case of Tubulointerstitial Nephritis and Uveitis Syndrome in Korea

Korean Journal of Nephrology 2008;27(5):606-610.

Soo Min Kim, M.D.1, Jae Uk Song, M.D.1, E Ryoung Choi, M.D.1, Hee Joung Choi, M.D.1 , Jung-Eun Lee, M.D.1 , Ghee Young Kwon, M.D.2, Woo Seong Huh, M.D.1, Yoon-Goo Kim, M.D.1, Dae-Joong Kim, M.D.1 and Ha-Young Oh, M.D.1

Department of Internal Medicine and pathology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea

증례 : 젊은 여자에서 발병한 간질성 신염 포도막염 증후군 1예

김수민1, 송재욱1, 최이령1, 최희정1, 이정은1, 권기영2, 허우성1, 김윤구1, 김대중1, 오하영1

성균관대학교 의과대학 삼성서울병원 내과학교실1, 병리학교실2

Abstract

We report a case of adult-onset tubulointerstitial nephritis and uveitis syndrome with Fanconi syndrome. A 31-year-woman presented with fever, anorexia, nausea, general weakness and weight loss for two months. Her initial laboratory findings showed anemia, high serum creatinine, hypouricemia, hypophosphatemia, hypokalemia, glucosuria, and proteinuria. She was diagnosed as having acute tubulointerstitial nephritis by renal biopsy. The etiology of tubulointerstitial nephritis was unclear. She was treated with systemic corticosteroid. Six months later and while the patient was still on systemic corticosteroid (Deflazacort 36 mg), bilateral uveitis developed. Renal function was recovered by systemic corticosteroid and mycophenolic acid. But ocular symptoms relapsed twice despite systemic corticosteroid treatment. The ocular symptoms improved after topical ophthalmic steroid drops and injection. Tubulointerstitial nephritis and uveitis syndrome should be considered in the differential diagnosis of the unexplained tubulointerstitial nephritis. And the need of the steroid treatment also should be considered in the case of adult-onset.

Key Words: Tubulointerstitial nephritis, Uveitis, Fanconi syndrome, Steroids