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2015 ; 94
(47
): e2101
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Tubulointerstitial Nephritis and Uveitis Syndrome in an Elderly Man: Case Report
and Literature Review
#MMPMID26632725
Lei WH
; Xin J
; Yu XP
; Li J
; Mao MF
; Ji JS
; Wu CF
; Zhu CY
; Jin L
Medicine (Baltimore)
2015[Nov]; 94
(47
): e2101
PMID26632725
show ga
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease of
unknown etiology defined by the combination of tubulointerstitial nephritis,
uveitis, and biochemical abnormalities. It has been reported that TINU mainly
affects adolescents and young women. Here we reported a special case regarding a
60-year-old man with acute renal failure due to TINU syndrome documented by renal
biopsy.We present a rare case of an elderly patient, who had been suffering from
a fever for 2 weeks, characterized by sudden onset and resolving spontaneously,
and accompanied by extreme fatigue, loss of appetite, and shivering. Renal biopsy
showed a tubulointerstitial nephritis, with polymorphonuclear infiltration and
acute tubulitis. In the outpatient clinic, he was diagnosed with idiopathic
bilateral anterior uveitis 1 month ago. Ophthalmological examination revealed
anterior asymptomatic bilateral uveitis. Human leukocyte antigen (HLA) typing
(HLA-DQA1*0101/0201 and HLA-DQB1*0303/0503) was found which supported the suspect
of TINU syndrome. The patient was treated with oral prednisone (1 mg/kg) and
continued for 8 weeks on tapering doses. Serum creatinine normalized within 3 and
6 months later renal function also recovered completely.This case highlights that
TINU syndrome is probably an underdiagnosed disease responsible for some cases of
idiopathic anterior uveitis in elderly male patients. It is of critical
importance to be aware of this syndrome by nephrologist and ophthalmologists in
this special population. Further studies are needed to elucidate clinical
characteristic and pathogenesis of TINU syndrome in elderly population.