Acute tubulointerstitial nephritis in two siblings and concomitant uveitis in one

Two sisters with acute tubulointerstitial nephritis (ATIN) are reported. The elder sister had concomitant uveitis which recurred twice. The younger sister became ill five years after the onset in the elder. Both patients had identical HLA haplotypes and also suffered from mild chronic sialoadenitis. A renal biopsy specimen of the elder sister showed not only marked interstitial infiltration of immunoglobulin-containing mononuclear cells but also immunecomplex-related glomerulonephritis. The younger sister had immune complexes in the serum. These findings suggest that glomerulonephritis and uveitis may be secondary phenomena of ATIN with participation of circulating immune complexes. Once the uveal involvement has occurred, uveitis may undergo relapses without any renal manifestations.