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Tubulointerstitial nephritis and uveitis syndrome: case report A 48-year-old woman developed tubulointerstitial nephritis and uveitis (TINU) syndrome during treatment with ivermectin and unspecified nonsteroidal anti-inflammatories for intra-hospital scabies. The woman presented with decreased visual acuity (VA), pain and redness in the right eye for 1 week. Ten years earlier, she had bilateral clear lens extraction for hyperopia, from which she had benefited. For 4 months, she had renal failure following supposedly toxic nephritis. She had been receiving treatment with ivermectin 12mg and unspecified nonsteroidal anti-inflammatories [routes not stated; not all dosages stated] for intra-hospital scabies. Reanal biopsy demonstrated acute tubulointerstitial nephritis. The woman underwent haemodialysis, but she progressed to chronic renal failure. Examination revealed corrected VA of 20/25 of the left eye and 20/40 of the right eye. Her right eye presented with corneal oedema, ciliary injection, anterior chamber Tyndall of 3+, predominantly inferior fine retro-corneal precipitates, posterior chamber implant covered with fibrin and inconspicuous posterior synechiae. Her left eye was white, the anterior chamber Tyndall was 1+ and cornea had fine diffuse retrodeskemetic precipitates. The eye tone and fundus were normal. The immune and infectious causes of uveitis were excluded. A reduced kidney function was noted with urea of 80 mg/dL, 1.83 mg/dL, urinary β-2 microglobulin 3390 mg/24h and glomerular filtration rate (GFR) 32.20 mL/min/1.73m2. HLA typing highlighted the HLA-DRB1*13*14 and HLA-DQB1*05*06 alleles. She started receiving treatment with prednisolone. Within 3 weeks, a clinical recovery was observed with calm biomicroscopic examination and VA of 20/20 bilaterally. Thereafter, local corticosteroids were maintained for 6 weeks systemic treatment methylprednisolone ( started for nephritis) for 3 months after her uveitis. Thereafter, she was followed-up annually, no recurrence was observed up to 50 months. Her last renal function test revealed urea of 44 mg/dL, creatine of 1.1 mg/dL and GFR of 55 mL/min/1.73m2 [time to reaction onset not stated]. Colard S, et al. Report of a new case of TINU syndrome. Journal Francais d’Ophtalmologie 42: e483-e484, No. 10, Dec 2019. Available from: URL: http://doi.org/10.1016/ 803499176 j.jfo.2019.03.020 [French; summarised from a translation]

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Reactions 5 Sep 2020 No. 1820