1/24. Immunomodulatory therapy for chronic tubulointerstitial nephritis-associated uveitis.PURPOSE: To describe the clinical course and treatment with immunomodulatory agents in patients with tubulointerstitial nephritis and uveitis syndrome. methods: Retrospective analysis of the charts of six patients with tubulointerstitial nephritis and uveitis syndrome. RESULTS: The mean ( /-SD) age was 24.3 ( /-16.5) years, range 13 to 49 years. Four patients were children, and two were adults. Three were men, and three were women. Five of the six patients had anterior uveitis, and one had panuveitis. All patients had several relapses despite treatment with topical, regional, and oral steroids and methotrexate in one case. The introduction or modification of immunosuppressants (methotrexate, azathioprine, or cyclosporin A) achieved control of the uveitis and prevented relapses over a mean ( /-SD) follow-up period of 19.66 ( /-10.01) months, range 6 to 34 months. No treatment-related side effects were observed. CONCLUSIONS: Tubulointerstitial nephritis and uveitis syndrome is a distinct disease entity in which the nephritis typically resolves, but the uveitis often becomes chronic and is treatment resistant. Immunomodulatory agents can achieve control of the inflammation and prevent relapses.- - - - - - - - - - ranking = 1keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
2/24. Tubulointerstitial nephritis and uveitis with bilateral multifocal choroiditis.PURPOSE: To report a case of bilateral multifocal choroiditis secondary to tubulointerstitial nephritis and uveitis. methods: Case report. A 16-year-old women with an 11-month history of tubulointerstitial nephritis and uveitis and bilateral anterior uveitis developed bilateral multifocal choroiditis. After initial unsuccessful treatment with topical steroids, treatment was augmented by a 2-week course of systemic prednisone. RESULTS: Intensive steroid treatment resulted in steroid-induced glaucoma, which required bilateral trabeculectomies, but the uveitis became inactive. Two years after uveitis onset, bilateral intraocular pressure was normal, there were occasional (12 ) anterior chamber cells, and inactive depigmented chorioretinal lesions on topical steroid drops. See also pp. 764-768, 798-799. CONCLUSIONS: Tubulointerstitial nephritis and uveitis usually involves only the anterior uvea, although a few cases of posterior uveitis have been described. This article reports a case of multifocal choroiditis associated with tubulointerstitial nephritis and uveitis. It is important for ophthalmologists to be aware of possible posterior uveal involvement in tubulointerstitial nephritis and uveitis so they can choose the most appropriate immunosuppressive therapy for the uveitis.- - - - - - - - - - ranking = 0.70414897346015keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
3/24. Tubulointerstitial nephritis and uveitis syndrome.BACKGROUND: Uveitis in association with tubulointerstitial nephritis is a distinct clinical entity known as tubulointerstitial nephritis and uveitis(TINU) syndrome. The onset of uveitis most commonly follows the onset of the interstitial nephritis, but may also occur before or concurrently. The uveitis is usually bilateral, nongranulomatous, limited to the anterior segment, and generally responds well to topical or oral (when indicated) anti-inflammatory treatment. Interestingly, recurrent or chronic uveitis is common, in contrast to the tubulointerstitial nephritis, which typically resolves completely. CASE REPORT: Approximately 5 months after a biopsy confirmed the diagnosis of tubulointerstitial nephritis, a 13-year-old boy was brought to our clinic with symptoms of a red, photophobic right eye of 3 days duration. Examination revealed nongranulomatous anterior-segment inflammation in the right eye greater than the left. The uveitis responded very well to topical steroid and cycloplegic treatment. Follow-up examinations have shown a gradual decrease in the inflammation, with no ocular complications. CONCLUSION: TINU syndrome is an under-recognized disorder and may account for some cases of uveitis otherwise characterized as 'idiopathic." Since the uveitis may be the presenting sign in up to 36% of cases of TINU syndrome, it is important for eye care practitioners to consider this disorder when searching for systemic associations with uveitis. Prompt detection through referral or testing will allow speedy diagnosis and appropriate treatment for both the uveitis and the tubulointerstitial nephritis.- - - - - - - - - - ranking = 0.86768364891942keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
4/24. Two cases of uveitis with tubulointerstitial nephritis in HTLV-1 carriers.BACKGROUND: Although the tubulointerstitial nephritis and uveitis (TINU) syndrome has been reported, there are only a few reports in the ophthalmological literature. The ocular findings usually appear later than the renal findings, and a renal biopsy is required for a definitive diagnosis. CASES: Case 1 was a 15-year-old Japanese girl who was a carrier of the human T lymphotropic virus, type 1 (HTLV-1). She had tubulointerstitial nephritis, anterior uveitis, posterior retinal edema in the right eye, and peripheral vasculitis OU. Case 2 was a 56-year-old Japanese woman who was also a carrier of HTLV-1. Previously she had been diagnosed with Graves' disease, anterior uveitis, and vitreous opacity. Several years later tubulointerstitial nephritis was diagnosed. OBSERVATIONS: In both patients interstitial nephritis was diagnosed and systemic steroid therapy was effective. CONCLUSIONS: It is difficult for ophthalmologists to diagnose the TINU syndrome because the renal biopsy is performed by a pediatrician or an internist. This may be why ophthalmologic descriptions are rare in cases of TINU syndrome, even though the ocular findings reported in the literature are characteristic. This is the first case report of TINU syndrome in patients with HTLV-1. Ophthalmologists should pay more attention to the uveitis in the TINU syndrome.- - - - - - - - - - ranking = 1.1547447825395keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
5/24. A case of adult-onset tubulointerstitial nephritis and uveitis ("TINU syndrome") associated with sacroileitis and Epstein-Barr virus infection with good spontaneous outcome.The authors report a case of tubulointerstitial nephritis and uveitis (TINU syndrome) in a 48-year-old woman. The patient's ocular symptoms (relapsing bilateral uveitis) began 4 months before the renal disease was diagnosed and were treated successfully with local steroid therapy. The main baseline laboratory findings were anemia, a rapid sedimentation rate, and a decreased renal function. urinalysis results showed mild proteinuria and some hyaline and hyaline-granular casts. Immunoglobulin (Ig) G and IgM antibodies to Epstein-Barr virus (EBV) were present. The renal biopsy showed interstitial lymphocytes and infiltration by rare plasma cells, tubular atrophy without granulomas, and slight expansion of the mesangium; electronic microscopy showed rare electron-dense deposits in the mesangium; no vascular alterations were seen, and immunofluorescent staining was uniformly negative. X-ray of the pelvis showed bilateral sacroileitis, which has been previously described in only 1 case of TINU syndrome; human leukocyte antigen B27 was negative. After 6 months without any therapy, all laboratory findings were normal; after 30 months, renal function was still normal, uveitis had not relapsed, but sacroiliac involvement was still present; EBV-viral capsid antigen (VCA) IgM were still high (28 UA/mL), and the EBV IgG titers were increased (VCA>170, EBV-nuclear antigen 108 UA/mL). This case confirms that this rare entity, originally observed in children, may occur and have a favorable spontaneous renal outcome also in the adult; EBV may play a role, as previously suggested. This is, to the authors' knowledge, the first reported case of TINU syndrome with the association of a well-documented bilateral sacroileitis.- - - - - - - - - - ranking = 0.81771707776857keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
6/24. Acute tubulointerstitial nephritis with uveitis syndrome presenting as multiple tubular dysfunction including Fanconi's syndrome.We describe an 11-year-old male patient with acute tubulointerstitial nephritis with uveitis (TINU) syndrome. He presented with easy fatigability, pallor, nocturia and weight loss. Laboratory examination disclosed anaemia, polyclonal hypergammaglobulinaemia, low molecular weight proteinuria, glycosuria, aminoaciduria, proximal and distal renal tubular acidosis, a urine concentration defect and decreased creatinine clearance. The multiple renal tubular dysfunction and slight glomerular dysfunction subsided spontaneously. Bilateral anterior uveitis was manifested 7 months after the onset of the disease. This is the first reported case of TINU syndrome with multiple proximal and distal tubular dysfunction including a complete type of Fanconi's syndrome.- - - - - - - - - - ranking = 0.81767337729633keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
7/24. choroiditis, pigment epithelial detachment, and cystoid macular edema as complications of poststreptococcal syndrome.PURPOSE: Two cases of poststreptococcal uveitis are presented. One patient developed nongranulomatous anterior uveitis (case 1). A second patient developed nongranulomatous anterior uveitis followed by granulomatous uveitis with concurrent choroiditis, retinal pigment epithelial detachment, and cystoid macular edema (case 2). Current concepts regarding the pathogenesis of poststreptococcal syndrome and its ocular sequelae are also discussed. case reports: Case 1: A 31-year-old female patient presented with bilateral nongranulomatous uveitis after a recent onset of sore throat. A past diagnosis of rheumatic fever was revealed during acquisition of the patient's history. blood chemistry analysis indicated elevated anti-streptolysin O antibody titers as the only significant elevated result. Case 2: A 33-year-old female presented initially with bilateral nongranulomatous uveitis. A history of recurrent sore throat was reported. blood chemistry analysis revealed elevated anti-streptolysin O antibody titers only. "Mutton fat" keratic precipitates eventually developed; however, the bilateral uveitis resolved after topical cycloplegic and corticosteroid treatment. An anterior granulomatous uveitis with concurrent choroiditis, retinal pigment epithelial detachment, and cystoid macular edema ensued during a recurrent episode. blood chemistry analysis was unremarkable at that time. CONCLUSIONS.: Anterior nongranulomatous/granulomatous and posterior uveitis should be considered clinical manifestations of poststreptococcal syndrome in patients with a clinical history and/or serological evidence indicating possible past streptococcal infection. A variation of host-genetic-predisposed immune response, the patient's human leukocyte antigen haplotype, pathogen virulence, and/or deposition location of immune circulating complexes may give rise to the diverse spectrum of clinical ocular sequelae in poststreptococcal syndrome. Poststreptococcal uveitis may comprise a similar immunologic pathogenesis to that of acute rheumatic fever, acute glomerulonephritis, and other autoimmune diseases.- - - - - - - - - - ranking = 0.0087898929197846keywords = nephritis (Clic here for more details about this article) |
8/24. Tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) with unilateral neuroretinitis: a case report.PURPOSE: To report a case of tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) with unusual unilateral neuroretinitis. methods: An 11-year-old girl who developed anterior uveitis 3 months after acute tubulointerstitial nephritis, without any etiologic factors for either nephritis or uveitis, is presented. RESULTS: Several days after the anterior uveitis, the patient presented with unilateral optic disk edema associated with a serous retinal detachment of the posterior pole, never previously described in TINU syndrome, leading to the formation of perifoveal intraretinal exudates. CONCLUSIONS: In spite of these posterior lesions, clinical course confirmed the previously reported favorable visual outcome of TINU syndrome treated with corticosteroids. It appeared that ocular impairment in TINU syndrome could be more diffuse and more extensive than previously described. As well as the whole uveal tract, the retina and the optic nerve may also be the ocular targets of the idiopathic inflammatory response in TINU syndrome.- - - - - - - - - - ranking = 0.37586746113679keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
9/24. Tubulointerstitial nephritis and uveitis syndrome: use of gallium scintigraphy in its diagnosis and treatment.Prompt diagnosis and treatment with corticosteroids of the tubulointerstitial nephritis with uveitis (TINU) syndrome may assist in the preservation of renal function. We present a case illustrating the characteristic clinical features of this syndrome. gallium scintigraphy assisted in the diagnosis and management of this case, which was complicated by relapsing pyelonephritis.- - - - - - - - - - ranking = 0.21233278567752keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
10/24. A case of tubulointerstitial nephritis and uveitis in an adult male.We report a case of tubulointerstitial nephritis and uveitis (TINU) syndrome in an adult male. A 40-year-old man was found to have bilateral anterior uveitis and mild renal insufficiency with high urinary beta-2 microglobulin. work up for connective tissue and infectious diseases were negative. His kidney function normalized spontaneously and remained normal at 1 year without intervention. Uveitis responded completely to local corticosteroid treatment and has not recurred.- - - - - - - - - - ranking = 0.81767337729633keywords = tubulointerstitial nephritis, tubulointerstitial, nephritis, interstitial nephritis, interstitial (Clic here for more details about this article) |
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