POS-059 SUCCESSFUL TREATMENT OF REFRACTORY TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME USING MYCOPHENOLATE MOFETIL

Tubulointerstitial nephritis and uveitis (TINU) syndrome is considered an autoimmune-mediated multisystemic disease. Its underlying mechanisms are not yet clear. Most patients with TINU adolescent girls (median age, 15 years). The diagnostic criteria for the presence of acute interstitial (diagnosed by renal histopathology analysis) typical uveitis. prognosis most seems to be self-limited. However, some develop refractory disease after initial steroid treatments. Here, we describe girl that was successfully treated mycophenolate mofetil (MMF). MMF immunosuppressant agent utilized as a steroid-sparing medication in autoimmune disease; it also used prevention organ transplant rejection. Our patient Department Pediatrics Developmental Biology at Tokyo Medical Dental University. treatment protocol involving approved our institutional review board. provided written informed consent publication this case report. A 13-year-old Japanese without significant past medical history referred hospital because photophobia low-molecular weight proteinuria. She complained malaise lateral abdominal pain. Laboratory examinations revealed elevated serum creatinine level, erythrocyte sedimentation rate, C-reactive protein well anemia hyperimmunoglobulinemia. Urinalysis showed mild proteinuria, glycosuria, urinary β2-microglobulin level (3380 μg/l 4303 μg/gCr; normal range, <200 μg/gCr) hematuria. had no symptoms or laboratory findings indicative Sjögren syndrome. Renal histology analysis moderate infiltration lymphocytes, including T B cells interstitium tubules, although glomerular abnormalities were present. Immunofluorescence did show any immunoglobulins complement components. Additionally, severe bilateral Thus, she diagnosed prednisolone (1** mg/kg/day). Satisfactory effects rapidly observed tapered. Subsequently, worsened gradually increased; thus, received additional combination mizoribine (MZR), immunosuppressive agent. Despite MZR, patient’s recurred followed tapering. Therefore, switched treatment. Her then improved all ranges. We have described MMF. suggest onset involve dysfunction. Further investigations necessary establish adequate fully elucidate