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Case report
Tubulointerstitial nephritis and uveitis (TINU) syndrome and recent Streptococcus infection in a 9-year-old girl
  1. Robert BR Moreton1,
  2. Brian W Fleck2,
  3. Joyce Davidson3 and
  4. David Hughes4
  1. 1Specialist Registrar in Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK
  2. 2Consultant Ophthalmologist, Princess Alexandra Eye Pavilion, Edinburgh, UK
  3. 3Consultant Paediatric Rheumatologist, Royal Hospital for Sick Children, Edinburgh, UK
  4. 4Consultant Paediatric Nephrologist, Royal Hospital for Children, Glasgow, UK
  1. Correspondence to Dr Robert BR Moreton; Bobby.moreton{at}gmail.com

Abstract

A 9-year-old girl presented to hospital with a 6-week history of non-specific constitutional symptoms and weight loss. She initially underwent extensive medical investigation without diagnosis being achieved. Although raised inflammatory markers and impaired renal function were noted during her initial admission to hospital, it was her subsequent presentation 2 weeks later with sudden-onset bilateral anterior uveitis that prompted a renal biopsy that indicated acute tubulointerstitial nephritis. A diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was made and systemic glucocorticoid treatment initiated to prevent visual loss and preserve renal function. She has subsequently been reviewed in multidisciplinary outpatient clinics and treated with a tapering regimen of immunosuppressive therapy. Her treatment has been complicated by the side effects of glucocorticoids and by persistent relapses in ocular disease and abnormalities on urinalysis. Recent clinical investigations indicate that her uveitis is controlled and that renal function remains well preserved.

  • eye
  • renal system
  • medical management
  • anterior chamber
  • proteinurea
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Footnotes

  • Contributors RBRM was the primary author of the manuscript but had no involvement in the clinical management of the patient. BWF, JD and DH were all involved in patient management and contributed to the authorship of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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