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Case Reports
. 2014 Sep 12:8:305.
doi: 10.1186/1752-1947-8-305.

Tubulointerstitial nephritis and uveitis syndrome complicated by IgA nephropathy and Graves' disease: a case report

Yoshinosuke Shimamura  1 , Takahiro Tsushima, Norihito Moniwa, Koichi Hasegawa, Yayoi Ogawa, Hideki Takizawa
Affiliations
Case Reports

Tubulointerstitial nephritis and uveitis syndrome complicated by IgA nephropathy and Graves' disease: a case report

Yoshinosuke Shimamura et al. J Med Case Rep. .

Abstract

Introduction: Tubulointerstitial nephritis and uveitis syndrome is a disorder characterized by a combination of acute tubulointerstitial nephritis and uveitis. Immunoglobulin A nephropathy is defined by the presence of immunoglobulin A deposits in glomerular mesangial areas. In this report, we describe a rare case of tubulointerstitial nephritis and uveitis syndrome complicated by immunoglobulin A nephropathy and Graves' disease, which was successfully treated with corticosteroids. To the best of our knowledge, this is the first time such a case has been documented since tubulointerstitial nephritis and uveitis syndrome was first described.

Case presentation: A 64-year-old Japanese woman presented with tubulointerstitial nephritis and uveitis syndrome accompanied by immunoglobulin A nephropathy and Graves' disease. She had renal dysfunction, proteinuria, and hematuria. Two weeks after her admission, she developed anterior chamber uveitis. She received corticosteroids, resulting in significant clinical improvement.

Conclusion: Tubulointerstitial nephritis and uveitis syndrome is a relatively uncommon cause of tubulointerstitial nephritis. Clinicians should recognize that tubulointerstitial nephritis and uveitis syndrome with immunoglobulin A nephropathy can occur in the presence of Graves' disease. Additionally, this report may provide important clues in terms of the management of a concomitant case of these diseases.

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Figures

Figure 1
Figure 1
Renal biopsy (periodic acid silver methenamine-Masson trichrome, ×40). Mild proliferation of mesangial cells (arrow head), with three or more cells per mesangial area, and increase of mesangial matrix (arrow).
Figure 2
Figure 2
Renal biopsy (immunofluorescence, ×400). Diffuse mesangial deposit of immunoglobulin A.
Figure 3
Figure 3
Renal biopsy (hematoxylin and eosin, ×40). In the renal tubular interstitium, marked immune cell infiltration, composed of mainly lymphocytes and edema, was observed (arrow). In addition, tubular atrophy was observed (arrow head).
See this image and copyright information in PMC

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