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Case Reports
. 2018 Jul-Sep;40(3):296-300.
doi: 10.1590/2175-8239-jbn-2018-0015. Epub 2018 Jun 18.

Tubulointerstitial nephritis and uveitis syndrome in children: report of three cases

[Article in English, Portuguese]
Cátia Pereira  1 , Joana Gil  1 , Inês Leal  2   3 , Patrícia Costa-Reis  4 , José Eduardo Esteves Da Silva  4 , Rosário Stone  4
Affiliations
Case Reports

Tubulointerstitial nephritis and uveitis syndrome in children: report of three cases

[Article in English, Portuguese]
Cátia Pereira et al. J Bras Nefrol. 2018 Jul-Sep.

Abstract
in English, Portuguese

Tubulointerstitial nephritis and uveitis syndrome is a rare and probably underdiagnosed condition. Renal and ocular manifestations may not occur simultaneously, making the diagnosis more difficult. Nephritis may be asymptomatic; therefore, renal function evaluation is essential for diagnosis. Urinary β2-microglobulin levels may be particularly useful. Uveitis, mostly anterior, nongranulomatous and bilateral, occurs usually after the onset of nephritis. Treatment includes corticosteroids and, eventually, other immunosuppressant agents. Renal disease is usually benign and resolves spontaneously or after treatment with systemic corticosteroids. Uveitis, however, may be chronic or recurrent. The authors described the cases of three pediatric patients diagnosed with tubulointerstitial nephritis and uveitis syndrome. The goal of this paper was to warn the medical community over the need to screen patients with uveitis for renal disease.

A síndrome nefrite tubulointersticial e uveíte é uma doença rara, provavelmente subdiagnosticada. As manifestações renais e oculares podem não ocorrer simultaneamente, tornando o diagnóstico mais difícil. A nefrite é geralmente assintomática, tornando fundamental a avaliação da função renal em doentes com uveíte. O doseamento da excreção urinária de β2-microglobulina é particularmente útil para o diagnóstico. A uveíte, tipicamente anterior, não granulomatosa e bilateral, manifesta-se após a nefrite na maioria dos casos. O tratamento inclui corticoides e, por vezes, outros imunossupressores. A doença renal tem evolução benigna, resolvendo-se espontaneamente ou com terapêutica com corticoides sistêmicos na maioria dos casos, no entanto, a uveíte pode ser crônica ou recorrente. Os autores descrevem três casos de síndrome nefrite tubulointersticial e uveíte, diagnosticados em idade pediátrica, e pretendem alertar para a necessidade de pesquisar sempre alterações renais nos doentes com uveíte.

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Figures

Figure 1
Figure 1. Renal histology for patient 1: renal interstices with lymphoplasmacytic inflammatory infiltrate.
See this image and copyright information in PMC

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References

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