In Reply.— Itami et al note the association of interstitial nephritis with bilateral, acute-onset anterior uveitis. As indicated in Table 1 of my article, 1 interstitial nephritis was diagnosed in 1.7% of patients attending my uveitis clinic. It ranked as the sixth most common systemic illness associated with uveitis.
In my published experience, 2 as well as that reported by others, 3-7 patients with uveitis and interstitial nephritis have systemic complaints that include fatigue, fever, anorexia, malaise, or abdominal pain. The uveitis characteristically begins acutely with a bilateral anterior component. In contrast to what is stated by Itami and colleagues, uveitis may precede, occur concomitantly, or follow the renal disease.2-7 My previously published recommendation that "all patients with a bilateral iritis in association with systemic complaints such as fatigue or fever should undergo careful evaluation of renal function, 2" agrees substantially with that of Itami. This approach is
ROSENBAUM JT. Acute Tubulointerstitial Nephritis With Uveitis-Reply. Arch Intern Med. 1990;150(3):688. doi:10.1001/archinte.1990.00390150154037