case_images: PMC11023721_01
case_images: Fluorescein angiogram revealing the following: (a) peripheral retinal vasculitis in the right eye; (b) papillitis and macular edema of the left eye.
case_images: CRIN2024-3909755.001.jpg
case_images: PMC11023721_01_CRIN2024-3909755.001.jpg
case_images: fig1
case_images: He underwent a fluorescein angiography which showed peripheral retinal vasculitis in the right eye and left-sided papillitis and macular edema, as shown in Figure 1.
case_images: (A) Interstitial mononuclear inflammatory infiltrate, of lymphocytic predominance; also seen is tubular involvement with destruction (tubulitis). Hematoxylin-Eosin, 400x. (B) The inflammatory infiltrate expands the interstitium, separating the tubules, some of which show atrophic changes, evidenced by a thickened and irregular basement membrane, highlighted in blue in this trichrome stain, 200x. (C) Normal glomeruli, without increase in cellularity nor mesangial or capillary wall damage. To the left of the glomerulus, there is the inflammatory infiltrate, limited by Bowman's capsule. Trichrome stain, 400x. (D) Electron microscopy (EM) revealing normal glomeruli, with normal podocytes, basal membrane, and endothelium. EM, 2500x.
case_images: CRIN2024-3909755.002.jpg
case_images: PMC11023721_01_CRIN2024-3909755.002.jpg
case_images: fig2
case_images: A kidney biopsy was ordered, which revealed interstitial edema and multiple foci of mononuclear inflammatory cells, with tubular epithelial exocytosis (tubulitis), several zones of fibrosis, and tubular atrophy in approximately 20% of the sample (Figure 2). Figure 2 shows the histopathologic findings of our patient, in which there is evidence of monocytic infiltration with lymphocytic predominance, affecting the interstitium and the tubules, with normal glomeruli.