Interstitial Nephritis with Concomitant Uveitis

Kikkawa, Y; Sakurai, Manabu; Mano, T; Hirabayashi, Kazuo; Kitagawa, Teruo

doi:10.1159/000399692

Cited by 22 publications

(22 citation statements)

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“…Although hypergammaglobulinemia is universally ob served in patients with this syndrome, and autoantibod ies, including rheumatoid factor [3,14,19] and ANA [4] have been found in some patients, a clear-cut immunolog ical disturbance has not been found until now. It is unlike ly that humoral immune mechanisms, such as anti-tubular basement membrane antibodies or immune com plexes, induce AIN because immunofluorescence studies of the tubules and interstitium have been negative in all patients including our case.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, cases of this syndrome have been reported not only in children [3][4][5][6][7][8][9][10][11], but also in adults [10,[12][13][14][15][16][17][18][19][20][21]. The common features of the syndrome are female predominance, gradual onset of general fa tigue, anorexia, fever, and/or weight loss, recurrent uvei tis, and spontaneous remission of AIN.…”

Section: Discussionmentioning

confidence: 99%

“…Granulomas and uveitis occur with infections, disorders of immunity and sys temic syndromes of unknown etiology [2], In 1975, Dobrin et al [3] reported a new syndrome in 2 patients with acute eosinophilic interstitial nephritis (AIN), bone mar row and lymph node granulomas and uveitis. Additional cases of the same syndrome have been reported recently [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21], The pathogenesis of the disease is not known although autoantibodies including rheumatoid factor [3,14,19] and antinuclear antibody (ANA) [4] have been found in some patients. While anti-neutrophil cytoplas mic antibodies (ANCA) have been detected in sera of patients with idiopathic and vasculitis-associated necro- hepatic tests and blood iron levels were normal.…”

Section: Introductionmentioning

confidence: 99%

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Acute Interstitial Nephritis and Uveitis with Bone Marrow Granulomas and Anti-IMeutrophil Cytoplasmic Antibodies

et al. 1995

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Acute interstitial nephritis (AIN) and uveitis of unknown etiology developed in a 15-year-old girl. Symptoms and urinary abnormalities improved spontaneously but moderate renal dysfunction and anterior uveitis persisted. A repeat biopsy performed 2 years later showed focal tubulointerstitial changes, while bone marrow examination revealed granulomas. Simultaneously, anti-neutrophil cytoplasmic antibodies (ANCA) were detected, and decreases in T cell population and lymphocyte function were found. These immunological abnormalities normalized in parallel with clinical improvement with corticosteroid therapy, strongly suggesting that in some patients autoimmune disorders contribute to the pathogenesis of the disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Interstitial Nephritis and Uveitis with Bone Marrow Granulomas and Anti-IMeutrophil Cytoplasmic Antibodies

et al. 1995

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“…El antigeno no ha sido determinado y puede ser autologo o ex6geno. La posibilidad de que se trate de un antigeno tubular aut61ogo fue planteada en un estudio realizado in vitro con leucocitos de 2 pacientes portadores de esta enfermedad, utilizando la prueba de inhibicion de migracion leucocitaria 15 . Entre los resultados de laboratorio de este y otros casos descritos destacan anemia normocitica normocromica, VHS elevada, IgG elevada, Ifrifocitos T y B disminuidos 13 .…”

Section: Comentariounclassified

Síndrome nefritis intersticial aguda y uveitis

1991

Rev. chil. pediatr.

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Interstitial nephritis and uveitisA nine year old male patient was admited to a metropolitan general hospital at Santiago, Chile, because of unexplained severe anemia (hematocrit 18%) and redness of the right eye. Uveitis was confirmed by ophthalmological examination. Laboratory work up showed an erithrocyte sedimentation rate of 101 mm • h, marked nitrogen retention (BUN 91 mg/dl), creatinine clearance was 9 ml/rnin • 1,73 sq m, serum IgG and IgM immune globulin concentrations were 2,368 mg/dl and 263 mg/dl respectively, over the normal range for age, with almost absent serum IgA and reduced T cell populations. Negative rheumathoid factor, antinuclear antibodies and anti smooth muscle antibodies reactions were obtained, together with normal levels of €3 and C^ fractions of complement and normal urine sediment. Renal biopsy specimen included 25 glomerulae, one of them was wholy sclerotic, another two had periglomerular fibrosis and the remaider showed only slightly increased mesangial matrix. Heavy mononuclear inflammatory interstitial infiltration, with granulomatous structures including giant multinuclear cells as those seen in foreign body reactions ( fig 1) and PAS possitive intraluminal tubular crystals were also observed. In spite of steroidal treatment, which was complicated by an inflammatory brain granuloma that healed in coincidence with parenteral antibiotic therapy, the patient evolved toward chronic renal failure. We think that the available evidence strongly suggests an immunological disorder as a very likely explanation for this case. (Key words: interstitial nephritis, uveitis.)La nefritis intersticial aguda se asocia con infecciones virales, bacterianas o parasitarias; hipersensibilidad a medicamentos (p.e,, antibioticos o antiinflamatorios no esteroidales); sustancias toxicas (compuestos halogenados -entre los que destacan tetracloruro de carbono y cloroformo-, la nafta y otros) o enfermedades en que se presentan alteraciones de la inmunidad (p.e., lupus, artritis reumatoidea). En 1975 Dobrin 1 describio un nuevo sfndrome, en la cual se asocian nefritis intersticial aguda y uveitis. A partir de esa fecha se han descrito mas de 35 casos de este si'ndrome en la literatura internacional. Las edades de estos pacientes fluctuaban entre 10 y 74 afios. En Chile no se ha descrito ningun caso. Presentamos a continuation la historia cli'nica de un paciente con nefritis intersticial aguda y uveitis. Caso ClinicoPaciente de 9 afios de edad, sexo masculino, cuyos sintomas comenzaron 20 dias antes de su ingreso al 1. Servick) de Pediatria. Hospital Clinico San BorjaArriaran. Unidad de Nefrologia Infantil. 2. Servicio de Anatomia Patologica. 252 hospital, con astenia, adinamia, dolores abdominales vagos y palidez de piel y mucosas, hematocrito (Ht) 18% y nitrogeno ureico sangui'neo (BUN) 83 mg/dl. En los antecedentes destacaba contacto, un mes antes de su hospitalizacion, con un plaguicida organofosforado y un aerosol usado como partidor en frio para motores, compuesto por una nafta liviana tipo hexano y un p...

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“…For this reason, the association of uveitis and TIN gives us few clues about the mechanism of pro duction of the latter [2]. Two cases described later [3] are of interest because the urine p2-microglobulin levels cor related with the clinical course of uveitis, and a positive leukocyte migration inhibitioin test was obtained using renal tubular antigen.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Immune Aspects of Idiopathic Acute Tubulointerstitial Nephritis and Uveitis Syndrome

Rodríguez‐Pérez¹,

Cruz-Alamo²,

Pérez-Aciego³

et al. 1995

Am J Nephrol

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Five patients with idiopathic interstitial nephritis and uveitis without bone marrow granulomas were followed-up for 1 year. Ophthalmological examination revealed bilateral anterior uveitis. Light microscopy of the renal tissue revealed predominant lymphocyte infiltration of the interstitium. Immunohistochemical analysis revealed a clear predominance of memory T lymphocytes (CD45RO+) in the interstitial and tubular infiltration. HLA typing, and immunophenotypic studies of peripheral blood mononuclear cells including absolute lymphocyte and monocyte counts were assessed. The patients’ peripheral T-cell subpopulation did not significantly differ from control studies. With steroid treatment maintained during a period of 6-9 months renal function and uveitis responded dramatically in all patients. After 1-year follow-up, only 1 patient showed a relapse of uveitis, but there was complete clinical recovery of the nephritis in all 5 patients. The aim of this study was to describe the 1-year follow-up of 5 new cases of acute tubulointerstitial nephritis and uveitis syndrome, and assess some aspects of their cellular immunity.

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Interstitial Nephritis with Concomitant Uveitis

Cited by 22 publications

References 0 publications

Acute Interstitial Nephritis and Uveitis with Bone Marrow Granulomas and Anti-IMeutrophil Cytoplasmic Antibodies

Acute Interstitial Nephritis and Uveitis with Bone Marrow Granulomas and Anti-IMeutrophil Cytoplasmic Antibodies

Síndrome nefritis intersticial aguda y uveitis

Clinical and Immune Aspects of Idiopathic Acute Tubulointerstitial Nephritis and Uveitis Syndrome

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