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

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.

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 a Helicobacter pylori and Strongyloides infection. We present the case of a middle-aged woman with concurrent IgA nephropathy and TINU syndrome, possibly following a H. pylori and Strongyloides infection. There was rapid and significant improvement of renal disease after glucocorticoid treatment.

Further research is needed to elucidate possible causality between IgA nephropathy, TINU syndrome, and the potential trigger factors involved.