Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy

  • Kim, Ji Eun (Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Park, Se Jin (Department of Pediatrics, Daewoo General Hospital, Ajou University School of Medicine) ;
  • Oh, Ji Young (Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Jeong, Hyeon Joo (Department of Pathology, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Ji Hong (Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Shin, Jae Il (Department of Pediatrics, Institute of Kidney Disease Research, Severance Children's Hospital, Yonsei University College of Medicine)
  • 투고 : 2014.08.01
  • 심사 : 2014.10.23
  • 발행 : 2016.11.15
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초록

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.

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참고문헌

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