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