Abstract: FR-PO0458
Tubulointerstitial Nephritis and Uveitis After COVID-19 Vaccination: A Case Report
Session Information
- AKI: Case Reports - TMA, Vasculitis, Immune-Mediated Injury, and Systemic Disease
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Pang, Bo, Albany Medical Center, Albany, New York, United States
- Maharjan, Helina, Albany Medical Center, Albany, New York, United States
- Ngo, Khoa, Albany Medical Center, Albany, New York, United States
- Faddoul, Giovanni, Albany Medical Center, Albany, New York, United States
Introduction
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare syndrome with triggers that include medications, infections, autoimmune diseases and other reported associations. We report a case occurring shortly after vaccination for COVID19.
Case Description
A 51-year-old female with history of hypothyroidism, migraine, prior COVID-19 infection received an mRNA COVID19 and influenza vaccination (day 0) and developed fever on day 7, yellow ocular flashers atypical for her migraine on day 8, ambulation-limiting lumbago/right hip pain, right eye pain and redness, left eye pain, redness and loss of visual acuity on day 14. Ophthalmology exam showed right eye uveitis (anterior)/scleritis (anterior and posterior), left eye anterior scleritis with corneal edema, and increased intraocular pressure (40 mm Hg). Left eye could only perceive light. Serologies and urine studies revealed acute kidney injury (peak creatinine 2.8 mg/dL on day 14–15), pyuria, proteinuria (UPCR 1.8 g/g), elevated inflammatory markers (CRP 186, ESR 109; ferritin 1497) without urinary symptoms. Rheumatology testing revealed solely an elevated C1q binding and low titer rheumatoid factor. Infectious workup was unremarkable except an asymptomatic Gardnerella vaginalis on urine culture. She received IV methylprednisolone (days 14–20) followed by a prednisone taper. Kidney biopsy (day 17) showed mixed tubulointerstitial inflammation, with differentials including pyelonephritis, TINU, drug reaction, and autoimmune disease. At day 24, musculoskeletal pain and proteinuria improved (UPCR 0.4 g/g), her right eye scleritis and uveitis resolved while her left eye symptoms persisted. Of note, she had a remote episode of scleritis that resolved with topical steroids.
Discussion
This case supports a temporal association between TINU and COVID19 vaccination. Pyelonephritis was unlikely and NSAID exposure was very brief. COVID19 infection associated nephritis and/or ocular inflammation are reported in the literature although no TINU cases are associated with influenza infection or vaccine. It is most likely that COVID19 vaccine triggered her autoimmune response.
Figure. (A) Right-eye uveitis/scleritis and left-eye scleritis with corneal edema. (B) Left eye with fluorescein staining.