PMC7158930_01
Anterior segment examination shows mutton fat keratic precipitates in the right eye
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F1
Slit-lamp examination of the right eye showed medium granulomatous keratic precipitates in the Arlt's triangle, 3+ cells in the anterior chamber [Figure 1], and 2+ cells in the anterior vitreous.
Fundus examination reveals a few snowball opacities in the inferior quadrant of the right eye (arrowhead)
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F2
Dilated fundus examination revealed 1+ vitreous haze in both eyes and a few snowball opacities, which were distributed in the inferior quadrant in the right eye [Figure 2].
Renal biopsy reveals widespread interstitial inflammation with tubulitis (arrows demonstrate lymphocytes). Glomerulus is unremarkable (H and E, x200; inset: H and E, x400)
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F3
The biopsy specimen showed diffuse interstitial inflammatory infiltrate with tubulitis, consistent with acute TIN [Figure 3].
In the biopsy specimen, CD4-positive T lymphocytes constitute the majority of infiltrating cells (immunohistochemistry, anti-CD4 Ab x200)
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F4
Majority of inflammatory cells were CD4-positive T lymphocytes (T helper cells), although accompanying CD8 (+) T-cells, plasmacytes, and scattered eosinophils were also present [Figure 4].