Rosales-Castillo A, Bustos-Merlo A, Aguilar JMP

Language: Spanish
References: 14
Page: 149-152
PDF size: 173.70 Kb.

ABSTRACT

TINU syndrome (tubulointerstitial nephritis and uveitis) is a rare entity first described in 1975 by Dobrin et al.(1) Since then, about 300 cases have been described in the literature.(2) It typically affects children and adolescents with a clear predominance in women (9:1 in some studies). This disease consists of the association of systemic inflammatory syndrome, with an increase in acute phase reactants, proximal tubulo-interstitial nephropathy (glucosuria, leukocyturia) and nongranulomatous bilateral anterior uveitis, in most cases. We present a case of this entity with favorable evolution and therapeutic response. The initial symptoms were nonspecific, but there was a significant deterioration in renal function, for which steroid treatment was carried out with a successful response and without new relapses during follow-up.

REFERENCES

1. Dobrin RS, Vernier RL, Fish AL. Acute eosinophilicinterstitial nephritis and renal failure with bonemarrow-lymph node granulomas and anterior uveitis.A new syndrome. Am J Med. 1975;59(3):325-33. doi:10.1016/0002-9343(75)90390-3.

2. Saarela V, Nuutinen M, Ala-Houhala M, ArikoskiP, Rönnholm K, Jahnukainen T. Tubulointerstitialnephritis and uveitis syndrome in children: a prospectivemulticenter study. Ophthalmology. 2013;120(7):1476-81. doi: 10.1016/j.ophtha.2012.12.039.

3. Saarela V, Nuutinen M, Ala-Houhala M, ArikoskiP, Rönnholm K, Jahnukainen T. Tubulointerstitialnephritis and uveitis syndrome in children: a prospectivemulticenter study. Ophthalmology. 2013;120(7):1476-81. doi: 10.1016/j.ophtha.2012.12.039.

4. Amaro D, Carreño E, Steeples LR, Oliveira-RamosF, Marques-Neves C, Leal I. Tubulointerstitialnephritis and uveitis (TINU) syndrome: a review.Br J Ophthalmol. 2020;104(6):742-7. doi: 10.1136/bjophthalmol-2019-314926.

5. Tan Y, Yu F, Yang H, Chen M, Fang Q, Zhao MH.Autoantibodies against monomeric C-reactive proteinin sera from patients with lupus nephritis are associatedwith disease activity and renal tubulointerstitiallesions. Hum Immunol. 2008;69(12):840-4. doi:10.1016/j.humimm.2008.09.006.

6. Mandeville JT, Levinson RD, Holland GN. Thetubulointerstitial nephritis and uveitis syndrome.Surv Ophthalmol. 2001;46(3):195-208. doi: 10.1016/s0039-6257(01)00261-2.

7. Carvalho TJ, Calça R, Cassis J, Mendes A.Tubulointerstitial nephritis and uveitis syndrome in afemale adult. BMJ Case Rep. 2019;12(1):e227688. doi:10.1136/bcr-2018-227688.

8. Simon AH, Alves-Filho G, Ribeiro-Alves MA.Acute tubulointerstitial nephritis and uveitiswith antineutrophil cytoplasmic antibody. Am JKidney Dis. 1996;28(1):124-7. doi: 10.1016/s0272-6386(96)90140-7.

9. Conz PA, Milan M, Bragantini L, La Greca G,Bevilacqua PA. TINU syndrome associated withreduced complement levels. Nephron. 2001;89(3):340-1. doi: 10.1159/000046096.

10. Pinheiro MA, Rocha MB, Neri BO, Parahyba IO,Moura LA, Oliveira CM, et al. TINU syndrome:review of the literature and case report. J Bras Nefrol.2016;38(1):132-6. doi: 10.5935/0101-2800.20160019.

11. Rueda-Rueda T, Sánchez-Vicente JL, Moruno-Rodríguez A, Castilla-Martino M, López-Herrero F,Contreras-Díaz M, et al. Tubulointerstitial nephritisand uveitis syndrome (TINU). Treatment withimmunosuppressive therapy. Arch Soc Esp Oftalmol.2018;93(1):47-51. doi: 10.1016/j.oftal.2017.01.008.

12. Clive DM, Vanguri VK. The syndrome oftubulointerstitial nephritis with uveitis (TINU).Am J Kidney Dis. 2018;72(1):118-28. doi: 10.1053/j.ajkd.2017.11.013.

13. Legendre M, Devilliers H, Perard L, Groh M, NeftiH, Dussol B, et al. Clinicopathologic characteristics,treatment, and outcomes of tubulointerstitialnephritis and uveitis syndrome in adults: A nationalretrospective strobe-compliant study. Medicine(Baltimore). 2016;95(26):e3964. doi: 10.1097/MD.0000000000003964.

14. Pakzad-Vaezi K, Pepple KL. Tubulointerstitial nephritisand uveitis. Curr Opin Ophthalmol. 2017;28(6):629-35. doi: 10.1097/ICU.0000000000000421.