ReviewBMC nephrology2025
Adalimumab in refractory pediatric tubulointerstitial nephritis and uveitis syndrome: a case report of sustained renal-ocular remission and literature review.
Review in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- [Noninfectious uveitis in childhood : Clinical aspects, diagnostics, treatment and transition].Die Ophthalmologie · 2026Review
- Navigating renal safety in the biologic treatment of psoriasis: from immunologic mechanisms to clinical practice.Frontiers in immunology · 2026Review
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Authors and funding
5 authors.
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Abstract
backgroundTubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease characterized by idiopathic acute tubulointerstitial nephritis and uveitis. To date, there are no standard therapeutic protocols. The renal damage may be clinically severe and persistent, and the uveitis tends to recur or progress to a chronic state, posing significant treatment challenges. We present a pediatric case of refractory TINU syndrome successfully treated with adalimumab, which provide a reference for its management. CASE PRESENTATION: A 7-year-old boy initially presented with mild proteinuria and acute kidney injury, accompanied by a reduced estimated glomerular filtration rate (eGFR) of 57.5 mL/min/1.73 m². A kidney biopsy revealed acute tubulointerstitial nephritis. He was treated with oral prednisolone, with partial improvement of kidney function. Three months after the first symptoms, bilateral anterior uveitis developed, establishing the diagnosis of TINU syndrome. Treatment initially involved systemic glucocorticoids combined with mycophenolate mofetil, but the uveitis persisted with recurrent episodes refractory to treatment. The patient received a 10-month course of adalimumab, a monoclonal antibody targeting Tumor necrosis factor-α (TNF-α). There was a significant resolution of ocular inflammation and normalization of kidney function, with a restored eGFR of 101.05 mL/min/1.73 m². Throughout the 1.25-year follow-up, no adverse events (including infections) occurred, and no recurrence was observed.
conclusionsAdalimumab can effectively control inflammatory responses and reduce recurrence in pediatric TINU syndrome, with a favorable safety profile, thereby providing a novel and promising biologic alternative for steroid-resistant or refractory cases. It is recommended to focus on ocular lesions in patients with tubulointerstitial injuries to avoid missing the diagnosis of TINU syndrome.
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