Tubulo Interstitial Nephritis and Uveitis Syndrome (TINU): Study of 5 Cases
Published: 2021-01-05
Page: 110-115
Issue: 2020 - Volume 3 [Issue 1]
Abir Derbel *
Department of Internal Medicine, Hedi Chaker Hospital, 3029 Sfax, Tunisia
Mariem Ghribi
Department of Internal Medicine, Hedi Chaker Hospital, 3029 Sfax, Tunisia
Manel Bouheli
Departement of Anatomopathology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia
Mouna Snoussi
Department of Internal Medicine, Hedi Chaker Hospital, 3029 Sfax, Tunisia
Sameh Marzouk
Department of Internal Medicine, Hedi Chaker Hospital, 3029 Sfax, Tunisia
Zouhir Bahloul
Department of Internal Medicine, Hedi Chaker Hospital, 3029 Sfax, Tunisia
*Author to whom correspondence should be addressed.
Abstract
Tubulo interstitial nephritis and uveitis syndrome (TINU) is a rare disease characterized by association of intraocular inflammation and nephritis. We report study of 5 cases of TINU syndrome collected retrospectively in the internal medicine departments from 1996 to 2012.
We found female predominance with female / male sex ratio at 4/1 and median age at 36.4 years. Uveitis was the first manifestation of the disease in all cases. 3 patients had systemic signs. All the patients had renal failure with proteinuria. Aseptic pyuria was noticed in 4 patients, microscopic hematuria in 2 patients and glucosuria without diabetes in one patient. All patients presented an elevated erythrocyte sedimentation rate. 3 patients had normochromic normocytic anemia and 2 patients had elevated level of gamma globulinemia. Kidney biopsy was performed in all patients. It showed acute interstitial nephritis in 1 case and chronic interstitial nephritis in 4 cases with segmental and focal glomerulosclerosis in 1 patient. All patients received oral corticosteroids. They were stopped in 3 cases and maintained in two cases. Residual renal failure was noticed in one case and one patient presented sequelae uveitis. One recurrence of uveitis was observed during progress after 2 years and a half. Progress was favorable. 3 patients had a good prognosis and the 2 others had an intermediate prognosis.
TINU syndrome should be considered in the presence of any uveitis associated with renal impairment. Multidisciplinary management is recommended for early diagnosis and effective treatment
Keywords: Uveitis, tubulo interstitial nephritis, corticosteroids, immunosuppressant