scholarly journals Tubulointerstitial Nephritis and Uveitis Syndrome: Case Series and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Beatriz Oliveira Lopes ◽  
Margarida Sena Brízido ◽  
Ana Cortesão Costa ◽  
Mário Raimundo ◽  
Margarida Maria Miranda ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Renal Involvement ◽  
Time Lag ◽  
Young Patients ◽  
Case Series ◽  
Posterior Uveitis ◽  
Rare Entity ◽  
Ocular Manifestations ◽  
Systemic Corticosteroids ◽  
Autoimmune Etiology

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.

scholarly journals Tubulointerstitial nephritis and uveitis syndrome in a female adult

2019 ◽  
Vol 12 (1) ◽  
pp. e227688
Author(s):  
Tiago J Carvalho ◽  
Rita Calça ◽  
João Cassis ◽  
Artur Mendes
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Renal Involvement ◽  
Precipitating Factors ◽  
Ocular Pain ◽  
Female Adult ◽  
Blurred Vision ◽  
Tinu Syndrome ◽  
Ocular Symptoms ◽  
Systemic Corticosteroids ◽  
High Degree

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease characterised by the association of acutetubulointerstitial nephritis and uveitis. It affects mainly children and young women. Drugs and infections may be precipitating factors. It is a diagnosis of exclusion. The mainstays of treatment are topical and systemic corticosteroids. Prognosis is usually favourable. We report a case of TINU which occurred in our unit. A 37-year-old woman presented with an influenza-like illness, bilateral ocular pain and blurred vision. Ophthalmological evaluation revealed bilateral anterior uveitis and later renal involvement was seen as acute tubulointerstitial nephritis. A diagnosis of TINU was assumed after exclusion of other systemic diseases. She was treated with topical corticosteroids for the uveitis and evolved favourably, with resolution of ocular symptoms and normalisation of serum creatinine and proteinuria. This case highlights the importance of a high degree of clinical suspicion to make the diagnosis of TINU syndrome.

scholarly journals An Adolescent Girl with Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome

2021 ◽  
Vol 2 ◽  
pp. 13-17
Author(s):  
Hana Setterquist ◽  
Kinsley Stepka
Keyword(s):  
Renal Disease ◽  
Adolescent Girl ◽  
Tubulointerstitial Nephritis ◽  
Acute Tubulointerstitial Nephritis ◽  
Tinu Syndrome ◽  
Ocular Manifestations ◽  
Systemic Corticosteroids ◽  
Appropriate Treatment

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare and poorly understood condition that is likely underdiagnosed. The possibility that uveitis and acute tubulointerstitial nephritis do not occur simultaneously may make diagnosis more difficult. Treatment consists of systemic corticosteroids and potentially non-steroid immunosuppressants. Renal disease usually resolves spontaneously or with appropriate treatment, however, ocular manifestations may be chronic or relapsing. We report a case of tubulointerstitial nephritis and uveitis syndrome in a 12-year-old female.

Recommendations for the management of ocular sarcoidosis from the International Workshop on Ocular Sarcoidosis

2020 ◽  
pp. bjophthalmol-2020-317354
Author(s):  
Hiroshi Takase ◽  
Nisha R Acharya ◽  
Kalpana Babu ◽  
Bahram Bodaghi ◽  
Moncef Khairallah ◽  
...  
Keyword(s):  
International Workshop ◽  
Immunosuppressive Drugs ◽  
Posterior Uveitis ◽  
Ocular Inflammation ◽  
Ocular Sarcoidosis ◽  
Ocular Manifestations ◽  
International Panel ◽  
Systemic Corticosteroids ◽  
Evaluation And Monitoring ◽  
Expert Recommendations

AimsTo establish expert recommendations for the management of ocular sarcoidosis (OS).MethodsA question-based survey on the management of OS was circulated to international uveitis experts (members of the International Uveitis Study Group and the International Ocular Inflammation Society) electronically. Subsequently, a consensus workshop was conducted at the 7th International Workshop on Ocular Sarcoidosis (IWOS) in June 2019 in Sapporo, Japan as part of the Global Ocular Inflammation Workshops. Statements on the management of OS that were supported by a two-thirds majority of 10 international panel members of the workshop, after discussion and voting, were taken as consensus agreement.ResultsA total of 98 participants from 29 countries responded to the questionnaire survey. The subsequent consensus workshop established recommendations for the management of OS in five sections. The first section concerned evaluation and monitoring of inflammation. The second, third and fourth sections described ocular manifestations that were indications for treatment, and the management of anterior uveitis, intermediate uveitis and posterior uveitis. In the fifth section, the use of systemic corticosteroids and systemic immunosuppressive drugs were detailed.ConclusionsRecommendations for management of OS were formulated through an IWOS consensus workshop.

scholarly journals OCULAR TOXOPLASMOSIS: A CASE REPORT

2021 ◽  
pp. 7
Author(s):  
Keyword(s):  
Case Report ◽  
Young Patients ◽  
Oral Prednisolone ◽  
Posterior Uveitis ◽  
Ocular Toxoplasmosis ◽  
White Female ◽  
World Population ◽  
Systemic Corticosteroids ◽  
Previous Infection ◽  
Patient Will

Introduction: Toxoplasmosis is caused by Toxoplasma gondii, mandatory intracellular protozoan. It’s estimated that one third of the world population is infected with the parasite, a fact that makes it one of the most infectious parasites. Although 80-90% of the immunocompetent infected are asymptomatic, the disease stands out for being one of the main causes of retinochoroiditis, especially among the immunosuppressed. Case report: Patient, 17 years old, white, female, previously healthy, comes to primary care due to a counter-referral with ophthalmology. Patient presented low visual acuity for 6 months, being diagnosed with ocular toxoplasmosis. Standard treatment was started: sulfadiazine, pyrimethamine, folinic acid and oral prednisolone for 6 weeks. Serum antitoxoplasma titers were obtained indicating previous infection: positive IgG and negative IgM. A patient will face another treatment cycle, as the condition doesn’t improve, which includes high doses of systemic corticosteroids. The physical examination showed no changes. The ophthalmologist requested periodic control of patient’s blood pressure and glucose, extending the treatment. Conclusion: In immunocompetent individuals, ocular toxoplasmosis is a consequence of reactivation of a scar that contained a previously inactive cyst, only a minority comes from a new infection. It’s considered the most common cause of posterior uveitis, emphasizing the importance of this report. Ocular reactivation occurs due to a decrease in specific immunity and the peak incidence is at 29 years old. Young patients with ocular toxoplasmosis have higher risk of recurrence when compared to elderly. Antitoxoplasma serology isn’t necessary for treatment, which must be started as clinical diagnosis is established.

scholarly journals The Effectiveness of Pre- and Postoperative Infliximab in Controlling Behçet’s Disease Posterior Uveitis in Patients Undergoing Vitrectomy: A Preliminary Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Hossam El Din Mohamed Khalil ◽  
Heba A. El Gendy ◽  
Hala Ahmed Raafat ◽  
Hazem Effat Haroun ◽  
Tamer Atef Gheita ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Immunosuppressive Drugs ◽  
Posterior Uveitis ◽  
Behcet's Disease ◽  
Ocular Manifestations ◽  
Systemic Corticosteroids ◽  
Before And After ◽  
Pars Plana

Purpose.To evaluate the short-term effectiveness of infliximab in controlling ocular manifestations in Behçet’s Disease (BD) patients candidate for pars plana vitrectomy, if given in a regimen before and after the planned procedure.Patients and Methods.30 eyes of 27 adult male BD patients with a mean age of 35.56 yrs presented with refractory posterior uveitis not responding to immunosuppressive drugs and candidate for vitrectomy were included. Infliximab was given in a dose of 5 mg/kg intravenous infusion once every two weeks for 3 treatment sessions before the intended vitrectomy followed by 3 treatment sessions at two-week intervals, after vitrectomy.Results.Improvement of ocular manifestations was noted in all eyes, with complete resolution in 26 eyes (87%). Visual acuity improved from 0.23 ± 0.11 to 0.38 ± 0.17 (p≤0.2), ESR decreased from 65.92 mm/hr ± 17.32 SD to 24.93 mm/hr ± 5.28 SD at the last treatment cycle (p≤0.1). The mean daily dose of systemic corticosteroids was tapered from 44.54 mg/d ± 2.89 to 8.48 mg/d ± 6.38 (p≤0.2), and no relapses were noted during the follow-up period.Conclusion.Infliximab may be safe and effective in controlling posterior uveitis and inducing remissions if given in a regimen before and after vitrecomy in BD patients.

scholarly journals Tubulointerstitial nephritis and uveitis syndrome in children: report of three cases

2018 ◽  
Vol 40 (3) ◽  
pp. 296-300
Author(s):  
Cátia Pereira ◽  
Joana Gil ◽  
Inês Leal ◽  
Patrícia Costa-Reis ◽  
José Eduardo Esteves Da Silva ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Disease ◽  
Pediatric Patients ◽  
Tubulointerstitial Nephritis ◽  
Medical Community ◽  
Function Evaluation ◽  
Β2 Microglobulin ◽  
Ocular Manifestations ◽  
Systemic Corticosteroids

ABSTRACT Tubulointerstitial nephritis and uveitis syndrome is a rare and probably underdiagnosed condition. Renal and ocular manifestations may not occur simultaneously, making the diagnosis more difficult. Nephritis may be asymptomatic; therefore, renal function evaluation is essential for diagnosis. Urinary β2-microglobulin levels may be particularly useful. Uveitis, mostly anterior, nongranulomatous and bilateral, occurs usually after the onset of nephritis. Treatment includes corticosteroids and, eventually, other immunosuppressant agents. Renal disease is usually benign and resolves spontaneously or after treatment with systemic corticosteroids. Uveitis, however, may be chronic or recurrent. The authors described the cases of three pediatric patients diagnosed with tubulointerstitial nephritis and uveitis syndrome. The goal of this paper was to warn the medical community over the need to screen patients with uveitis for renal disease.

Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

2019 ◽  
Vol 1 (1) ◽  
pp. 49-56
Author(s):  
Mariam M. Mirambo ◽  
Lucas Matemba ◽  
Mtebe Majigo ◽  
Stephen E. Mshana
Keyword(s):  
Virus Infection ◽  
Neural Tube ◽  
Zika Virus ◽  
English Language ◽  
Case Reports ◽  
Case Series ◽  
Epidemiological Studies ◽  
Ocular Manifestations ◽  
Zika Virus Infection ◽  
N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

2019 ◽  
Vol 1 (1) ◽  
pp. 49-56
Author(s):  
Mariam M. Mirambo ◽  
Lucas Matemba ◽  
Mtebe Majigo ◽  
Stephen E. Mshana
Keyword(s):  
Virus Infection ◽  
Neural Tube ◽  
Zika Virus ◽  
English Language ◽  
Case Reports ◽  
Case Series ◽  
Epidemiological Studies ◽  
Ocular Manifestations ◽  
Zika Virus Infection ◽  
N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

scholarly journals POS-474 TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS : A CASE SERIES

2021 ◽  
Vol 6 (4) ◽  
pp. S205
Author(s):  
T. JHIDRI ◽  
M. Ben Salem ◽  
A. Letaief ◽  
M. Hamouda ◽  
M. Ben salah ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Case Series
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