Tubulointerstitial Nephritis and Uveitis Syndrome: Case Series and Literature Review.

Case Reports in Ophthalmological Medicine
Beatriz Oliveira LopesSusana Morais Pina

Abstract

Tubulointerstitial nephritis and uveitis syndrome (TINU) is a rare oculorenal inflammatory entity with a probable autoimmune etiology. Interstitial nephritis may be asymptomatic and usually has a benign course with spontaneous resolution. Uveitis, instead, is classically anterior, bilateral, and nongranulomatous, but it can be unilateral and presents as posterior uveitis or panuveitis, sometimes with a chronic or recurrent evolution. The frequent time lag of ocular and renal manifestations makes this diagnosis particularly challenging. The authors describe four cases of this rare entity, two with tubulointerstitial nephritis preceding ocular manifestations and the remaining, instead, with uveitis preceding renal involvement. The therapeutic approach included systemic corticosteroids in all cases. The addition of immunosuppressive therapy was required in three patients to achieve uveitis control. TINU is probably an underrecognized entity and should always be considered in the differential diagnosis of a chronic or recurrent idiopathic uveitis, especially in young patients who may have mild and asymptomatic renal disease.

References

Dec 12, 2001·Survey of Ophthalmology·J T MandevilleG N Holland
Jan 31, 2003·Investigative Ophthalmology & Visual Science·Ralph D LevinsonGary N Holland
Apr 23, 2008·International Ophthalmology Clinics·David M Hinkle, C Stephen Foster
Aug 15, 2008·Acta Ophthalmologica·Veronica Holm ThomassenKirsten Baggesen
Oct 13, 2012·Korean Journal of Ophthalmology : KJO·Jeong Mo HanSe Joon Woo
Sep 25, 2015·Ocular Immunology and Inflammation·María Camila AguilarAlejandra de-la-Torre
Apr 7, 2016·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Marcelo A PinheiroMarcos Kubrusly
Aug 12, 2016·International Ophthalmology·Takamitsu NagashimaNobuhisa Mizuki
May 24, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Mark A LuscoCharles E Alpers
Aug 15, 2017·Current Opinion in Ophthalmology·Kaivon Pakzad-Vaezi, Kathryn L Pepple

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