Simultaneous Appearance of Immunoglobulin A Nephropathy and Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome: A Case Report

Background: Immunoglobulin A (IgA) nephropathy usually occurs after upper respiratory tract infection. The currently widely accepted pathomechanism involves genetic predisposition, formation of galactose-deficient IgA1, and production of autoantibodies against these IgA, ultimately leading to mesangial deposition of immune complexes. TINU (Tubulointerstitial Nephritis and Uveitis) syndrome is a rare disease with a suspected autoimmune mechanism, although the exact etiology and pathomechanism are not fully understood. To our knowledge, only a few cases with simultaneous occurrence of these two entities have been reported in common literature so far. Case presentation: A 53-year-old Ethiopian woman presented with a month of postprandial nausea, vomiting, occipital headache, 5-kilogram weight loss and intermittent night sweats. Laboratory examinations revealed hematuria and impaired renal function, histological findings showed acute tubulointerstitial nephritis and glomerulonephritis. Further assessments revealed left-sided anterior uveitis as well as a Helicobacter pylori and Strongyloides infection. We present the case of a middle-aged woman with concurrent IgA nephropathy and TINU syndrome, possibly following a Helicobacter pylori and Strongyloides infection. There was rapid and significant improvement of renal disease after glucocorticoid treatment. Conclusion: Further research is needed to elucidate possible causality between IgA nephropathy, TINU syndrome, and the potential trigger factors involved.