Tubulointerstitial Nephritis and Uveitis Syndrome with non Caseating Granuloma in Bone Marrow Biopsy

Authors

  • Maria Fraga Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
  • Maria João Nunes da Silva Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
  • Margarida Lucas Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
  • Rui M. Victorino Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.3981

Abstract

The Tubulointerstitial Nephritis and Uveitis syndrome is a very rare condition, probably under-diagnosed in clinical practice. It is
characterized by the combination of an interstitial nephritis and uveitis, and is an exclusion diagnosis. Tissue non caseating granuloma can be rarely present, with only 6 cases reported on bone marrow. We present a case of a 55 year old female with a 3-month history of asthenia and weight loss. Blood tests showed anemia and renal insufficiency. Renal biopsy revealed interstitial nephritis and the bone marrow biopsy showed caseating granuloma. One month later anterior uveitis of the left eye appeared. An extensive exclusion of all possible causes allowed a diagnosis of Tubulointerstitial Nephritis and Uveitis syndrome with caseating granuloma in bone marrow. As ocular and renal manifestations may not occur simultaneously, Tubulointerstitial Nephritis and Uveitis Syndrome should be systematically considered in cases of interstitial nephritis and/or uveitis, and tissue granulomas can be part of this rare syndrome.

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Author Biographies

Maria Fraga, Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Interna do Complementar de Medicina Interna

Maria João Nunes da Silva, Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Assistente Hospitalar Graduada de Medicina Interna

Mestre em Cuidados Paliativos e Assistente convidada da Faculdade de Medicina de Lisboa

Margarida Lucas, Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Rui M. Victorino, Serviço de Medicina 2. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

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Published

2014-04-30

How to Cite

1.
Fraga M, Nunes da Silva MJ, Lucas M, Victorino RM. Tubulointerstitial Nephritis and Uveitis Syndrome with non Caseating Granuloma in Bone Marrow Biopsy. Acta Med Port [Internet]. 2014 Apr. 30 [cited 2024 Nov. 5];27(2):268-70. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/3981

Issue

Section

Case Report