Department of Paediatric Nephrology, Royal Manchester Children’s Hospital, Manchester, UK.
Nephrol Dial Transplant. 2011 Sep;26(9):3060-2. doi: 10.1093/ndt/gfr352. Epub 2011 Jun 14.
We report for the time a patient with recurrence of tubulointerstitial nephritis and uveitis (TINU) following renal transplantation. Our patient was diagnosed at the age of 8 years and, despite treatment with systemic steroids, developed established renal failure. At the age of 17 years, he underwent a live-related donor renal transplant. Immunosuppression included tacrolimus, mycophenolate mofetil and prednisolone. Having had normal renal function for 3 years after transplantation, he developed uveitis and decline in the graft function. A biopsy of the allograft demonstrated recurrent granulomatous interstitial nephritis. The recurrence of TINU following transplantation suggests a role for circulating autoantibodies in the disease pathology.
我们首次报告了一例肾移植后发生复发性肾小管间质性肾炎和葡萄膜炎(TINU)的患者。该患者 8 岁时被诊断为 TINU,尽管接受了全身皮质类固醇治疗,但仍发展为终末期肾衰竭。17 岁时,他接受了活体亲属供肾移植。免疫抑制方案包括他克莫司、霉酚酸酯和泼尼松龙。移植后 3 年内肾功能正常,后出现葡萄膜炎和移植物功能下降。移植肾活检显示复发性肉芽肿性间质性肾炎。移植后 TINU 的复发提示循环自身抗体在疾病发病机制中起作用。