1/5. Prolonged prodrome, systemic vasculitis, and deafness in Cogan's syndrome.Cogan's syndrome is a rare, multisystem disease which occurs predominantly in children and young adults. It was originally described as the combination of interstitial keratitis and audiovestibular disturbance, but other forms of ocular disease, as well as systemic vasculitis, have since been recognised as part of the syndrome. diagnosis can be difficult if the various manifestations occur separately, but early recognition is important because prompt treatment may prevent deafness. Two cases are presented here illustrating the features of this disease, and providing histological evidence of systemic vasculitis in both.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
2/5. Tubulointerstitial nephritis and uveitis syndrome associated with hyperthyroidism.We report a 17-year-old male patient with tubulointerstitial nephritis and uveitis (TINU) associated with hyperthyroidism. He presented with a 2-month history of fatigue, loss of appetite, low-grade fever, and a 12-kg weight loss when he was admitted to our hospital. He had iritis, which was complicated by fibrin in the anterior chamber, diagnosed by slit-lamp examination. On laboratory examinations, deteriorated renal function (blood urea nitrogen level was 25.9 mg/dl and creatinine level was 2.82 mg/dl) and elevated urinary levels of N-acetyl-beta-D-glucosaminidase (33.1 U/l) and beta2-microglobulin (78,600 microg/l) were observed. serum thyroid-stimulating hormone (TSH) was undetectable, at less than 0.01 microIU/ml, and free triiodothyronine and free thyroxine were elevated, up to 5.23 pg/ml and 2.85 ng/dl, respectively. The titers of antithyroglobulin and antithyroid microsomal and TSH-receptor antibodies were not elevated. Abdominal and thyroidal ultrasonography showed evident bilateral enlargement of the kidneys and diffuse enlargement of the thyroid gland. iodine-123 scintigraphy showed low uptake in the thyroid gland. The biopsied renal specimen showed mild edema and severe diffuse infiltration of mononuclear cells and few eosinophils in the interstitium, without any glomerular or vascular abnormalities. Based on the clinical features and pathological findings, a diagnosis of TINU syndrome with associated hyperthyroidism was made. Treatment was started with 30 mg/day of prednisolone. The iritis disappeared, and the patient's clinical status improved remarkably. This case suggests the possibility of thyroid dysfunction in some patients with TINU syndrome, and we believe thyroid function should be measured in all TINU patients. Moreover, histopathological diagnosis of the thyroid glands before treatment is necessary for TINU patients with thyroid dysfunction.- - - - - - - - - - ranking = 961.73227820446keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial (Clic here for more details about this article) |
3/5. Cogan's syndrome: a treatable cause of neurosensory deafness.Cogan's syndrome, nonsyphilitic interstitial keratitis associated with vestibuloauditory deficits, can vary in its presentation. This paper describes an unusual case in which deafness developed while the patient was receiving topical therapy with prednisolone and homatropine for mild bilateral iritis and right-sided nodular episcleritis. The 10-year-old boy's hearing improved dramatically with high-dose systemic steroid therapy. The importance of being aware that deafness may occur in children undergoing treatment for "routine" iritis is emphasized.- - - - - - - - - - ranking = 1keywords = interstitial (Clic here for more details about this article) |
4/5. Acute interstitial nephritis and iritis. Renal-ocular syndrome.Acute renal failure developed in a previously healthy woman in association with acute iritis. Renal biopsy revealed acute mononuclear interstitial nephritis. Known systemic illnesses that can present as acute renal failure and have ocular manifestations of iritis/uveitis were excluded by detailed testing and observation during a 24-month period. No cause for this renal-ocular syndrome was discovered. There was a dramatic improvement to normal renal function and complete resolution of ocular findings following a two-month course of steroid therapy.- - - - - - - - - - ranking = 290.73333618274keywords = nephritis, interstitial (Clic here for more details about this article) |
5/5. Primary tubulointerstitial nephritis and uveitis syndrome.Primary acute tubulointerstitial nephritis and uveitis is an uncommon syndrome involving the kidney and eye. Although rare, to date 28 cases having been reported, it is important to recognise this entity to facilitate appropriate investigation and treatment. We report an unusual case of this syndrome in which the patient suffered a relapse of her nephritis concurrently with the onset of the first episode of uveitis. Both responded to treatment, although the uveitis subsequently recurred.- - - - - - - - - - ranking = 3702.8747135279keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial (Clic here for more details about this article) |