Tubulointerstitial nephritis and uveitis syndrome: An atypical case

Abstract

Tubulointerstitial nephritis and uveitis syndrome is an uncommon clinical entity. Usually, renal involvement is moderate, and uveitis is acute, bilateral, anterior, and nongranulomatous (revised). We present the case of a 55-year-old female patient who went to the emergency department with complaints of asthenia, myalgia, and paresthesia. One week later, she complained of photophobia and was diagnosed with bilateral nongranulomatous acute anterior uveitis. The next day, due to hypotension and acute kidney injury, the patient was hospitalized. Renal biopsy showed tubulointerstitial nephritis. The patient was started on oral prednisolone, achieving uveitis resolution and renal function stability. After slow corticoid reduction, the patient presented uveitis recurrence complicated with bilateral optic disc (revised) edema and cystoid macular edema (CME) in the left eye. After oral prednisolone reduction, the patient suffered another relapse with CME worsening. We decided to initiate methotrexate 7.5 mg/week, achieving ocular and renal function stability.