Simultaneous Appearance of Immunoglobulin A Nephropathy and Tubulointerstitial Nephritis and Uveitis Syndrome: A Case Report

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Abstract Introduction Immunoglobulin A (IgA) nephropathy usually occurs after upper respiratory tract infection. The currently widely accepted pathomechanism involves genetic predisposition, formation of galactose-deficient IgA1, and production of autoantibodies against these IgA, ultimately leading to mesangial deposition of immune complexes. Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease with a suspected autoimmune mechanism, although the exact etiology and pathomechanism are not fully understood. To our knowledge, only a few cases with simultaneous occurrence of these two entities have been reported in common literature so far. Case Presentation A 53-year-old Ethiopian woman presented with a month of postprandial nausea, vomiting, occipital headache, 5 kilogram weight loss and intermittent night sweats. Laboratory examinations revealed hematuria and impaired renal function, histological findings showed acute tubulointerstitial nephritis and glomerulonephritis. Further assessments revealed left-sided anterior uveitis as well as aandinfection. We present the case of a middle-aged woman with concurrent IgA nephropathy and TINU syndrome, possibly following aandinfection. There was rapid and significant improvement of renal disease after glucocorticoid treatment. Conclusion Further research is needed to elucidate possible causality between IgA nephropathy, TINU syndrome, and the potential trigger factors involved.