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2017 ; 12
(1
): 128
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Tubulointerstitial nephritis and uveitis (TINU) syndrome: a systematic review of
its epidemiology, demographics and risk factors
#MMPMID28709457
Okafor LO
; Hewins P
; Murray PI
; Denniston AK
Orphanet J Rare Dis
2017[Jul]; 12
(1
): 128
PMID28709457
show ga
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare oculorenal
inflammatory condition that was first described in 1975. In 2001 a major review
identified 133 cases in the world literature and proposed key diagnostic criteria
for the condition. Although acknowledged as rare, the limited data available
prevented reliable estimates of the prevalence of the condition, and hampered
elucidation of the relationship between genetic and environmental factors that
contribute to its pathogenesis.In this review we have performed a systematic
search on the epidemiology, demographics and proposed risk factors for TINU.
Estimates of prevalence based on studies that explicitly report TINU cases
suggest that it is diagnosed in 0.2-2% of patients attending specialist uveitis
services, with variation reflecting a number of factors including level of
diagnostic certainty required. The prevalence of uveitis in patients with
tubulointerstitial nephritis (TIN) may be higher than currently recognised,
particularly in the paediatric population.The prevalence of TINU is higher in
younger age groups and there is a female preponderance although this gender
effect appears weaker than suggested by early studies. Although important genetic
contributions have been proposed, the small size of studies and variation between
reports currently preclude identification of a 'pro-TINU' haplotype. Drugs and
infections have been proposed as the leading acquired risk factors for the
development of TINU; whilst the small size of TINU cohorts and issues of study
design limit interpretation of many studies. Larger datasets from the renal
literature suggest that the majority of these cases are precipitated by a
drug-induced hypersensitivity reaction; however in many ophthalmic cases no clear
precipitant is identified.