American Academy of Ophthalmology
Herlitz et al describe a case report of a 44-year-old woman who presented to her ophthalmologist with iritis. Soon after, she became febrile, fatigued and anorexic. Blood work, a chest X ray and a renal biopsy showed that the patient had extensive tubulitis. After she was placed on a course of oral prednisone at 60 milligrams per day, her symptoms eventually resolved. The pathologic findings seen in acute interstitial nephritis (AIN) include interstitial inflammation, tubulitis and tubular degenerative changes. The researchers indicate that AIN and tubular interstitial nephritis are the same disease.
AIN can have a number of etiologies, including tubulointerstitial-nephritis-associated uveitis (TINU). Because sarcoidosis is a common cause of uveitis and can cause AIN- or TINU-like changes, it is important to rule out sarcoidosis in any patient who appears to have TINU.