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Purt B, Hiremath S, Smith S, et al. A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach. Am J Case Rep. 2016;17:869-873doi: 10.12659/ajcr.900701.
Purt, B., Hiremath, S., Smith, S., Erzurum, S., & Sarac, E. (2016). A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach. The American journal of case reports, 17869-873. https://doi.org/10.12659/ajcr.900701
Purt, Boonkit, et al. "A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach." The American journal of case reports vol. 17 (2016): 869-873. doi: https://doi.org/10.12659/ajcr.900701
Purt B, Hiremath S, Smith S, Erzurum S, Sarac E. A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach. Am J Case Rep. 2016 Nov 21;17:869-873. doi: 10.12659/ajcr.900701. PMID: 27867184; PMCID: PMC5119685.
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Am J Case Rep. 2016 Nov 21;17:869-873. doi: 10.12659/ajcr.900701.

A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach.

The American journal of case reports

Boonkit Purt, Siri Hiremath, Sarah Smith, Sergul Erzurum, Erdal Sarac

Affiliations

  1. , Madigan Army Medical Center, Tacoma, WA, USA.
  2. Department of Internal Medicine and The Transitional Residency, St. Elizabeth Youngstown Hospital, Youngstown, OH, USA.
  3. , Eye Care Associates, Poland, OH, USA.
  4. Department of Surgery, Northeast Ohio Medical University, Rootstown, OH, USA.
  5. Department of Medicine, Northeast Ohio Medical University, Nephrology Associates, Inc., Rootstown, OH, USA.

PMID: 27867184 PMCID: PMC5119685 DOI: 10.12659/ajcr.900701

Abstract

BACKGROUND It is important for an ophthalmologist and nephrologist to look for hidden causes of uveitis and nephritis, respectively. Delay in diagnosis leads to increased morbidity and failure to systemically manage the patient results in future recurrence of disease. It is likely that TINU remains underdiagnosed and could potentially account for some of the cases of idiopathic uveitis, especially when greater than 50% of uveitis cases have no identifiable cause. Fewer than 300 cases of tubulointerstitial nephritis and uveitis (TINU) syndrome have been reported. In TINU syndrome, inflammation affects the renal tubules, interstitial tissue, and uveal tract. Its pathogenesis remains poorly understood. CASE REPORT We report a rare case of TINU syndrome in a 23-year-old female who was treated using a multispecialty approach. Her primary care physician diagnosed her with proteinuria and acute kidney injury and referred her to the nephrologist, who later referred her to the ophthalmologist. A left kidney biopsy confirmed acute interstitial nephritis. Following the discovery of a "pink eye", the patient was referred to ophthalmology and diagnosed with anterior uveitis, confirming TINU syndrome. Without the additional findings of uveitis, the diagnosis would have been missed. Resolution was obtained through steroid therapy. CONCLUSIONS Correctly diagnosing TINU syndrome requires a multispecialty approach and may not be obvious upon initial presentation. Therefore, the ophthalmologist needs to consider TINU in the differential diagnosis for a patient with bilateral uveitis and evaluate a urinalysis for proteinuria as part of the work up.

Conflict of interest statement

Conflicts of Interest: None declared Conflict of interest The authors declare no conflicts of interest.

References

  1. Iran J Kidney Dis. 2011 Jan;5(1):66-8 - PubMed
  2. Ophthalmology. 2007 May;114(5):995-9 - PubMed
  3. Pediatr Nephrol. 1992 Nov;6(6):547-9 - PubMed
  4. Clin Nephrol. 2007 Apr;67(4):255-9 - PubMed
  5. Nephron. 2001 Nov;89(3):340-1 - PubMed
  6. Clin Exp Nephrol. 2011 Oct;15(5):765-8 - PubMed
  7. CMAJ. 2013 Jan 8;185(1):56-9 - PubMed
  8. Am J Ophthalmol. 2005 Oct;140(4):637-41 - PubMed
  9. Clin Kidney J. 2014 Aug;7(4):420-1 - PubMed
  10. Saudi J Kidney Dis Transpl. 2006 Sep;17(3):386-9 - PubMed
  11. CMAJ. 2009 Mar 3;180(5):535-8 - PubMed
  12. Am J Ophthalmol. 1996 Jan;121(1):35-46 - PubMed
  13. Nephrol Dial Transplant. 1993;8(9):821-6 - PubMed
  14. Ren Fail. 2006;28(4):355-9 - PubMed
  15. Clin J Am Soc Nephrol. 2014 Jan;9(1):21-8 - PubMed
  16. Clin J Am Soc Nephrol. 2011 Jan;6(1):93-100 - PubMed
  17. Am J Kidney Dis. 1996 Jul;28(1):124-7 - PubMed
  18. Am J Case Rep. 2015 Feb 28;16:119-23 - PubMed
  19. Acta Ophthalmol. 2009 Sep;87(6):676-9 - PubMed
  20. Surv Ophthalmol. 2001 Nov-Dec;46(3):195-208 - PubMed
  21. Ann Pharmacother. 2004 Jan;38(1):41-5 - PubMed
  22. Nephrology (Carlton). 2005 Aug;10(4):418-20 - PubMed
  23. Br J Clin Pharmacol. 2007 Dec;64(6):819-23 - PubMed
  24. Clin Nephrol. 2009 Oct;72(4):315-8 - PubMed
  25. Pediatrics. 2001 Jun;107(6):1443-6 - PubMed
  26. Am J Kidney Dis. 2003 Sep;42(3):E4-10 - PubMed
  27. Invest Ophthalmol Vis Sci. 2003 Feb;44(2):653-7 - PubMed

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