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.

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.

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: Are Drugs Offenders or Bystanders?

2016 ◽  
Vol 9 ◽  
pp. CCRep.S36862 ◽  
Author(s):  
Mutsumi Kawamata ◽  
Tetsu Akimoto ◽  
Taro Sugase ◽  
Naoko Otani-Takei ◽  
Takuya Miki ◽  
...  
Keyword(s):  
Clinical Course ◽  
Tubulointerstitial Nephritis ◽  
Late Onset ◽  
Acute Interstitial Nephritis ◽  
Drug Induced ◽  
Histological Assessment ◽  
Tinu Syndrome ◽  
Ocular Manifestations ◽  
Renal Abnormalities

A 16-year-old female patient was admitted to our hospital due to progressive renal dysfunction with an increased serum creatinine (sCr) level of 1.7 mg/dL. Her clinical course without any ocular manifestations and results of drug-induced, lymphocyte-stimulating tests, in addition to a renal histological assessment, initially encouraged us to ascribe the patient's renal abnormalities to drug-induced acute interstitial nephritis (AIN). Four months later, she started to complain about reduced visual acuity when she was found to have anterior bilateral uveitis despite the recovered renal function with almost constant sCr levels around 0.7 mg/dL. Thus, a diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was finally made. Our case illustrates the difficulties in distinguishing late-onset uveitis TINU syndrome from drug-induced AIN at the time of the renal biopsy, thereby suggesting the importance of a longitudinal follow-up to overcome the potential underdiagnosis of the disease. Several diagnostic conundrums that emerged in this case are also discussed.

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.

Acute tubulointerstitial nephritis in children and chronic kidney disease

2019 ◽  
Vol 26 (5) ◽  
pp. 290-294 ◽  
Author(s):  
S. Clavé ◽  
C. Rousset-Rouvière ◽  
L. Daniel ◽  
M. Tsimaratos
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tubulointerstitial Nephritis ◽  
Acute Tubulointerstitial Nephritis

scholarly journals Urinary Cytokines Reflect Renal Inflammation in Acute Tubulointerstitial Nephritis: A Multiplex Bead-Based Assay Assessment

2021 ◽  
Vol 10 (13) ◽  
pp. 2986
Author(s):  
Laura Martinez Valenzuela ◽  
Juliana Draibe ◽  
Oriol Bestard ◽  
Xavier Fulladosa ◽  
Francisco Gómez-Preciado ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Urinary Concentration ◽  
Blood Eosinophil ◽  
Acute Tubulointerstitial Nephritis ◽  
Luminex Assay ◽  
Non Invasive ◽  
Urinary Levels ◽  
Histological Data ◽  
The Individual ◽  
Multiplex Bead

Background: Acute tubulointerstitial nephritis (ATIN) diagnosis lays on histological assessment through a kidney biopsy, given the absence of accurate non-invasive biomarkers. The aim of this study was to evaluate the accuracy of different urinary inflammation-related cytokines for the diagnostic of ATIN and its distinction from acute tubular necrosis (ATN). Methods: We included 33 patients (ATIN (n = 21), ATN (n = 12)), and 6 healthy controls (HC). We determined the urinary levels of 10 inflammation-related cytokines using a multiplex bead-based Luminex assay at the time of biopsy and after therapy, and registered main clinical, analytical and histological data. Results: At the time of biopsy, urinary levels of I-TAC/CXCL11, CXCL10, IL-6, TNFα and MCP-1 were significantly higher in ATIN compared to HC. A positive correlation between the extent of the tubulointerstitial cellular infiltrates in kidney biopsies and the urinary concentration of I-TAC/CXCL11, MIG/CXCL9, CXCL10, IL17, IFNα, MCP1 and EGF was observed. Notably, I-TAC/CXCL11, IL-6 and MCP-1 were significantly higher in ATIN than in ATN, with I-TAC/CXCL11 as the best discriminative classifier AUC (0.77, 95% CI 0.57–0.95, p = 0.02). A combinatory model of these three urinary cytokines increased the accuracy in the distinction of ATIN/ATN compared to the individual biomarkers. The best model resulted when combining the three cytokines with blood eosinophil and urinary leukocyte counts (LR = 9.76). Follow-up samples from 11ATIN patients showed a significant decrease in I-TAC/CXCL11, MIG/CXCL9 and CXCL10 levels. Conclusions: Urinary I-TAC/CXCL11, CXCL10, IL6 and MCP-1 levels accurately distinguish patients developing ATIN from ATN and healthy individuals and may serve as novel non-invasive biomarkers in this disease.

Cockayne syndrome with recurrent acute tubulointerstitial nephritis

2006 ◽  
Vol 56 (11) ◽  
pp. 678-682 ◽  
Author(s):  
Satoshi Funaki ◽  
Shori Takahashi ◽  
Hitohiko Murakami ◽  
Kensuke Harada ◽  
Hiroshi Kitamura
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Cockayne Syndrome ◽  
Acute Tubulointerstitial Nephritis

scholarly journals Acute Tubulointerstitial Nephritis in a Patient on Anti-Programmed Death-Ligand 1 Triggered by COVID-19: A Case Report

2021 ◽  
Vol 8 ◽  
pp. 205435812110147
Author(s):  
Dimitry Buyansky ◽  
Catherine Fallaha ◽  
François Gougeon ◽  
Marie-Noëlle Pépin ◽  
Jean-François Cailhier ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Tubulointerstitial Nephritis ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
High Dose ◽  
Programmed Death Ligand 1 ◽  
Acute Tubulointerstitial Nephritis ◽  
Programmed Death ◽  
Kidney Involvement

Rationale: Immune checkpoint inhibitors are monoclonal antibodies used in the treatment of various types of cancers. The downside of using such molecules is the potential risk of developing immune-related adverse events. Factors that trigger these autoimmune side effects are yet to be elucidated. Although any organ can potentially be affected, kidney involvement is usually rare. In this case report, we describe the first known instance of a patient being treated with an inhibitor of programmed death-ligand 1 (anti-PD-L1, a checkpoint inhibitor) who develops acute tubulointerstitial nephritis after contracting the severe acute respiratory syndrome coronavirus 2. Presenting concerns of the patient: A 62-year-old patient, on immunotherapy treatment for stage 4 squamous cell carcinoma, presents to the emergency department with symptoms of lower respiratory tract infection. Severe acute kidney injury is discovered with electrolyte imbalances requiring urgent dialysis initiation. Further testing reveals that the patient has contracted the severe acute respiratory syndrome coronavirus 2. Diagnosis: A kidney biopsy was performed and was compatible with acute tubulointerstitial nephritis. Interventions: The patient was treated with high dose corticosteroid therapy followed by progressive tapering. Outcomes: Rapid and sustained normalization of kidney function was achieved after completion of the steroid course. Novel findings: We hypothesize that the viral infection along with checkpoint inhibitor use has created a proinflammatory environment which led to a loss of self-tolerance to renal parenchyma. Viruses may play a more important role in the pathogenesis of autoimmunity in this patient population than was previously thought.

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