Titre du document / Document title

Tubulointerstitial nephritis with uveitis: clinico-pathological and immunological study

Auteur(s) / Author(s)

LITWIN Mieczysław ⁽¹⁾ ; MICHAŁKIEWICZ Jacek ^{(2 3)} ; JARMUZEK Wioletta ⁽¹⁾ ; WOZNIEWICZ Bogdan ⁽⁴⁾ ; GRENDA Ryszard ⁽¹⁾ ; IWANICKA Katarzyna ⁽⁴⁾ ; MADALINSKI Kazimierz ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Nephrology and Kidney Transplantation, The Children's Memorial Health Institute, Warsaw, POLOGNE
⁽²⁾ Department of Nephrology and Kidney Transplantation, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-736 Warsaw, POLOGNE
⁽³⁾ Department of Immunology, Medical Academy, Bydgoszcz, POLOGNE
⁽⁴⁾ Department of Pathomorphology, The Children's Memorial Health Institute, Warsaw, POLOGNE

Résumé / Abstract

A 10-year-old boy was evaluated for fever, weight loss, uveitis, normocytic, normochromic anemia, renal insufficiency, and hypergammaglobulinemia of 8 weeks' duration. Infectious and neoplastic causes of fever were excluded. A renal biopsy performed in the 4th week of disease revealed diffuse plasmocytic interstitial nephritis. No treatment was prescribed and the patient was transferred to another hospital. Because clinical symptoms and renal insufficiency were still present, in the 8th week of disease a second biopsy was performed, which showed lympho-monocytic interstitial nephritis. At the same time, phenotypic analysis of peripheral blood mononuclear cells was carried out, revealing a significantly decreased number of CD3⁺, CD4⁺, and CD3⁺/CD8⁺ cells, increased non-T CD3^-/CD8⁺ and CD56⁺ NK cells, and decreased naïve (CD45RA⁺/CD4⁺) and memory (CD45RO⁺/CD8⁺) T lymphocytes. A 6-month course of oral prednisone was prescribed. Clinical symptoms and laboratory findings quickly returned to normal values. After 13 days of corticosteroid therapy, a second phenotypic analysis of peripheral blood mononuclear cells was performed, which revealed normalization of CD3⁺, CD4⁺, and CD3⁺/CD8⁺ cells as well as proportions of non-T CD8⁺ and CD56⁺ NK lymphocytes, naïve and memory cells. This case shows spontaneous evolution of tubulointerstitial infiltrates from plasmacytic to lympho-monocytic, profound disturbances of the immunological system, and the beneficial effect of corticosteroids on both the clinical course and immunological disturbances.

Revue / Journal Title

Pediatric nephrology   ISSN 0931-041X   CODEN PENED3 

Source / Source

2002, vol. 17, n^o8, pp. 683-688 (21 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Heidelberg, ALLEMAGNE  (1987) (Revue)

Mots-clés anglais / English Keywords

Uvea disease ; Eye disease ; Kidney disease ; Urinary system disease ; Human ; Corticosteroid ; Evolution ; T-Lymphocyte ; Immunosuppressive agent ; Treatment ; Chemotherapy ; Prednisone ; Immunopathology ; Child ; Uveitis ; Tubulointerstitial nephritis ;

Mots-clés français / French Keywords

Uvée pathologie ; Oeil pathologie ; Rein pathologie ; Appareil urinaire pathologie ; Homme ; Corticostéroïde ; Evolution ; Lymphocyte T ; Immunodépresseur ; Traitement ; Chimiothérapie ; Prednisone ; Immunopathologie ; Enfant ; Uvéite ; Néphropathie tubulointerstitielle ;

Mots-clés espagnols / Spanish Keywords

Uvea patología ; Ojo patología ; Riñón patología ; Aparato urinario patología ; Hombre ; Corticoesteroide ; Evolución ; Linfocito T ; Inmunodepresor ; Tratamiento ; Quimioterapia ; Prednisona ; Inmunopatología ; Niño ; Uveitis ; Nefropatía tubulointersticial ;

Localisation / Location

INIST-CNRS, Cote INIST : 21216, 35400010449362.0220