title: Clinical features in tubulointerstitial nephritis and uveitis (TINU) syndrome.
abstract: OBJECTIVE
  To analyze clinical features of the tubulointerstitial nephritis and uveitis (TINU) syndrome in Japan, especially exacerbations or recurrences of uveitis.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  We reviewed the clinical features in 12 patients with TINU syndrome diagnosed by renal biopsy, who were evaluated and treated at the Department of Ophthalmology, Hokkaido University Hospital. Visual acuity was measured using decimal visual acuity.
  
  
  RESULTS
  Patient age ranged from 10 to 33 years (mean 21 years), and females accounted for 83% of the cases. Both eyes were affected in 11 patients (92%). All 12 patients initially experienced ocular symptoms, with hyperemia being the chief complaint. We diagnosed patients as having uveitis and conducted blood tests and urinalysis. Urinalysis did show characteristic findings, most notably glucosuria, increased beta2 microglobulin that were > or = 10 times that of normal levels, and increased N-acetylglucosaminidose levels in a high percentage of patients. Recurrent or exacerbating uveitis was seen in six patients (50%). In exacerbated or recurrent uveitis, inflammation was more severe (> or = 3+ cells of the anterior eye segment). The ocular inflammation generally responded well to treatment with oral corticosteroids, and the number of recurrences was lower at corticosteroid doses of > or = prednisolone 40 mg.
  
  
  CONCLUSIONS
  Ophthalmologists play an important role in the initial discovery of patients with TINU syndrome. Because inflammation was more severe in exacerbated or recurrent uveitis, in instances where uveitis is refractory to local therapy, oral corticosteroids should be considered as early as possible.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. cgoda@med.hokudai.ac.jp
authors.forename: Chiho
authors.initials: C
authors.lastname: Goda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kotake
authors.forename: Akira
authors.initials: A
authors.lastname: Ichiishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Namba
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Kitaichi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Ohno
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis; D008297:Male; D009395:Nephritis, Interstitial / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012008:Recurrence; D012189:Retrospective Studies; D013577:Syndrome; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids