mycophenolic-acid and Uveitis--Anterior

Acute granulomatous tubulointerstitial nephritis (GTIN) is a rare finding in renal biopsy. Differential diagnosis is facilitated when GTIN is associated with granulomatous bilateral anterior uveitis (GBAU). Nevertheless, differentiation between a rare form of granulomatous tubulointerstitial nephritis and uveitis syndrome (TINU) and sarcoidosis can be challenging. We report a case of biopsy-proven GTIN with concomitant GBAU, leading to a dead-end diagnosis. We discuss workup and propose a diagnostic algorithm based on a literature review. We also report a successful treatment of ophthalmologic and renal relapse using mycophenolate mofetil.

Topics: Acute Disease; Humans; Mycophenolic Acid; Nephritis, Interstitial; Uveitis; Uveitis, Anterior

Autoimmune uveitis is an acute, recurrent, sight-threatening disease that can lead to severe visual loss and blindness. It requires systemic immunosuppressive therapy and continuous monitoring by ophthalmologist and rheumatologist. There are no universally accepted referral patterns for the treatment of endogenous uveitis. Most specialists indicate corticosteroids, methotrexate and cyclosporine A as the first use drugs. Anti-cytokine drugs are a new opportunity for the patients unresponsive to the conventional anti-inflammatory and immunosuppressive therapy.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal; Autoimmune Diseases; Azathioprine; Cyclosporine; Glucocorticoids; Humans; Immunosuppressive Agents; Methotrexate; Mycophenolic Acid; Prednisolone; Uveitis, Anterior

Topics: Cyclophosphamide; Drug Therapy, Combination; Glucocorticoids; Granuloma; Granulomatosis with Polyangiitis; Humans; Injections, Intravenous; Male; Methotrexate; Methylprednisolone; Middle Aged; Mycophenolic Acid; Prednisone; Pulse Therapy, Drug; Remission Induction; Uveitis, Anterior

Topics: Adolescent; Adult; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Immunosuppressive Agents; Middle Aged; Mycophenolic Acid; Prednisolone; Recurrence; Uveitis, Anterior; Uveomeningoencephalitic Syndrome