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Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations

We here describe three different clinical manifestations of tubulointerstitial nephritis and uveitis (TINU) syndrome. We examined and diagnosed the following 3 patients: a 15-year-old boy with bilateral anterior uveitis (Case 1), a 14-year-old girl with bilateral papilledema (Case 2), and a 49-year-...

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Autores principales: Nagashima, Takamitsu, Ishihara, Mami, Shibuya, Etsuko, Nakamura, Satoshi, Mizuki, Nobuhisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440544/
https://www.ncbi.nlm.nih.gov/pubmed/27511057
http://dx.doi.org/10.1007/s10792-016-0321-5
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author Nagashima, Takamitsu
Ishihara, Mami
Shibuya, Etsuko
Nakamura, Satoshi
Mizuki, Nobuhisa
author_facet Nagashima, Takamitsu
Ishihara, Mami
Shibuya, Etsuko
Nakamura, Satoshi
Mizuki, Nobuhisa
author_sort Nagashima, Takamitsu
collection PubMed
description We here describe three different clinical manifestations of tubulointerstitial nephritis and uveitis (TINU) syndrome. We examined and diagnosed the following 3 patients: a 15-year-old boy with bilateral anterior uveitis (Case 1), a 14-year-old girl with bilateral papilledema (Case 2), and a 49-year-old woman with panuveitis (Case 3). The findings are presented herein. Case 1: The patient had bilateral anterior uveitis. Urinalysis revealed markedly increased β2-microglobulin and N-acetyl-β-d-glucosaminidase levels. As the patient was pathologically diagnosed with tubulointerstitial nephritis (TIN), we diagnosed TINU based on the presence of both uveitis and TIN. He was treated with oral corticosteroids. Case 2: This patient showed anterior uveitis and papilledema in both eyes. On initial examination, the urine test results did not show any abnormality. Three months later, high β2-microglobulin and N-acetyl-β-d-glucosaminidase levels were detected. As the patient was clinically diagnosed with TIN, we subsequently diagnosed TINU. Both the ocular and renal findings improved without treatment. Case 3: The patient developed bilateral panuveitis, retinal vasculitis, and macular edema, which were initially suspected to be sarcoidosis. However, she was pathologically diagnosed with TIN 12 months before the onset of uveitis; therefore, she was finally diagnosed with TINU. She recovered with local corticosteroid administration only. TINU may present with fundal features in addition to anterior uveitis. Detailed history taking and urinalysis are important to determine the presence of tubular disorders in similar patients.
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spelling pubmed-54405442017-06-08 Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations Nagashima, Takamitsu Ishihara, Mami Shibuya, Etsuko Nakamura, Satoshi Mizuki, Nobuhisa Int Ophthalmol Case Report We here describe three different clinical manifestations of tubulointerstitial nephritis and uveitis (TINU) syndrome. We examined and diagnosed the following 3 patients: a 15-year-old boy with bilateral anterior uveitis (Case 1), a 14-year-old girl with bilateral papilledema (Case 2), and a 49-year-old woman with panuveitis (Case 3). The findings are presented herein. Case 1: The patient had bilateral anterior uveitis. Urinalysis revealed markedly increased β2-microglobulin and N-acetyl-β-d-glucosaminidase levels. As the patient was pathologically diagnosed with tubulointerstitial nephritis (TIN), we diagnosed TINU based on the presence of both uveitis and TIN. He was treated with oral corticosteroids. Case 2: This patient showed anterior uveitis and papilledema in both eyes. On initial examination, the urine test results did not show any abnormality. Three months later, high β2-microglobulin and N-acetyl-β-d-glucosaminidase levels were detected. As the patient was clinically diagnosed with TIN, we subsequently diagnosed TINU. Both the ocular and renal findings improved without treatment. Case 3: The patient developed bilateral panuveitis, retinal vasculitis, and macular edema, which were initially suspected to be sarcoidosis. However, she was pathologically diagnosed with TIN 12 months before the onset of uveitis; therefore, she was finally diagnosed with TINU. She recovered with local corticosteroid administration only. TINU may present with fundal features in addition to anterior uveitis. Detailed history taking and urinalysis are important to determine the presence of tubular disorders in similar patients. Springer Netherlands 2016-08-10 2017 /pmc/articles/PMC5440544/ /pubmed/27511057 http://dx.doi.org/10.1007/s10792-016-0321-5 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Nagashima, Takamitsu
Ishihara, Mami
Shibuya, Etsuko
Nakamura, Satoshi
Mizuki, Nobuhisa
Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title_full Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title_fullStr Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title_full_unstemmed Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title_short Three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
title_sort three cases of tubulointerstitial nephritis and uveitis syndrome with different clinical manifestations
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440544/
https://www.ncbi.nlm.nih.gov/pubmed/27511057
http://dx.doi.org/10.1007/s10792-016-0321-5
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