Uveitis and Acute Interstitial Nephritis: What to Expect

Villalba, Noël Lorenzo; Robayna, Silvia Marrero; Medina, Davinia Ramírez; Casas, S. Moreno; Pérez, José Carlos Rodríguez

doi:10.12890/2014_000111

Cited by 1 publication

(4 citation statements)

References 5 publications

(5 reference statements)

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“…There are no specific serum markers or laboratory findings that are unique to patients with TINU syndrome [40][41][42], but In order to look for a specific blood test, Krebs Von Den Lunge-6 (KL6) and modified CRP (mCRP) antibodies were found to be elevated in patients with TINU syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Sterile leukocyturia (55%), glucosuria (47%), predominantly tubular proteinuria (86%), hematuria (43%) and eosinophilia may also be observed, anaemia (96%), slightly abnormal liver function tests and evidence of systemic inflammation : an elevated ESR (89%) and CRP, elevated serum IgG levels were also obsrved with increase of polyclonal gamma globulin concentrations [9,15,19,42].…”

Section: Discussionmentioning

confidence: 99%

“…Repeatability of this test is not valid, a second test performed on the same blood sample will typically be 19% greater than the initial test, for which we did not repeat the test for the patient [45]. The definite diagnosis of TINU syndrome requires a renal biopsy, and consistent with acute interstitial nephritis which is characterized by renal interstitial edema and infiltration by inflammatory cells with relative sparing of the glomerular and vascular structures on renal biopsy [9,42]. Renal tubulointerstitial infiltrates are composed of lymphocytes, plasma cells and activated macrophages.…”

Section: Discussionmentioning

confidence: 99%

“…Many other diseases can cause renal and eye damage (Table 5). Drug induced AIN should be ruled out, it is also difficult to distinguish patients with TINU syndrome and late-onset uveitis from those with drug-induced interstitial nephritis [42].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome, Two New Cases and Review of the Literature

Laidoudi¹,

Hakem²

2016

J Nephrol Ther

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Case 1: A 25 year-old woman, presented with asthenia; weight loss; severe hypertension and acute unilateral anterior uveitis. She had also proteinuria; hematuria; aciduria; kidney failure and grade I hypertensive retinopathy. Kidney biopsy showed a non caseating granuloma in the interstitial tissue, and tubulointerstitial nephritis (TIN) with granulomatous lesions in the medullary parenchyma. All explorations were negative but QuantiFERON was 10 times normal without koch's bacillus. No other sites of granulomas. The patient partially responded to corticoid treatment. She replased after untimely stopping corticosteroids. Corticosteroid-sparing was provided by mycophenolate mofetil.Case 2: A 46 year-old patient, with family history of mother who died of CKD, presented with recurrent anterior uveitis, kidney failure, proteinuria, and inflammatory syndrome, research of infectious agents or auto-immunity origin was negative. Renal biopsy showed TIN lesions in subacute stage; biopsy of the salivary glands showed stage III chronic lymphocytic sialadenitis without Sjogren syndrome or sarcoidosis. The patient received corticosteroid treatment. Discussion:The presence of TIN, recurrent anterior uveitis, no notion of drug intake, response to corticosteroids and exclusion of other diagnoses leads to TINU syndrome. Positivity of Quantiferon is explained by the fact that TINU syndrome is associated with high serological markers in the absence of their corresponding diseases, and presence of chronic lymphocytic sialadenitis explained by these immunological disorders without Sjogren syndrome, Both patients remained well without recurrence of uveitis 2 and 6 years later respectively. Conclusion:TINU syndrome is secondary to immunological disorders as evidenced interstitial infiltrate of the renal parenchyma, the inflammatory disease of the uvea and good response to corticosteroid therapy.

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Section: Discussionmentioning

confidence: 99%