Tubulointerstitial nephritis and uveitis syndrome in a patient with diabetic nephropathy: a case report and literature review.

BACKGROUND: The coexistence of tubulointerstitial nephritis and uveitis (TINU) syndrome with diabetic nephropathy is an uncommon clinical occurrence and poses diagnostic challenges. CASE PRESENTATION: A 63-year-old female patient presented with ocular pain, conjunctival congestion, blurred vision, and photophobia. These manifestations were followed by a rapid deterioration of renal function. Renal biopsy revealed histopathological features consistent diabetic nephropathy, including interstitial nephritis and acute tubular injury. Ophthalmologic evaluation demonstrated bilateral anterior uveitis. After exclusion of other primary etiologies, a diagnosis of TINU syndrome complicated by diabetic nephropathy was established. Following treatment with glucocorticoids, ocular symptoms, renal dysfunction, and systemic inflammatory markers demonstrated marked improvement. CONCLUSION: TINU syndrome should be considered in individuals with diabetic nephropathy who develop acute kidney injury and concurrent uveitis. Early diagnosis through histopathological evaluation and multidisciplinary management are critical for improving clinical outcomes.